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NK-/T-Cell Lymphoma Resembling Hydroa Vacciniforme With Positive CD4 Marker Expression

A Diagnostic Difficulty

Zhang, Guiying, MD*; Bai, Harrison X., BA; Yang, Li, MD*; Ma, Michael H., MD†,‡; Su, Yuwen, MD*; Luo, Yangyang, MD*; Wen, Haiquan, MD*; Lu, Qianjin, MD, PhD*; Xiao, Rong, MD, PhD*

The American Journal of Dermatopathology: February 2013 - Volume 35 - Issue 1 - p 94–97
doi: 10.1097/DAD.0b013e3182674895
Brief Report

Abstract: A 35-year-old Chinese woman presented with a 2.5-year history of facial swelling in the left lower quadrant and a 10-month history of relapsing red papules and vesicles in the perioral area resembling hydroa vacciniforme. Histologically, a tissue biopsy showed a dense infiltration of medium-sized atypical lymphocytic cells expressing CD4 and CD56. A diagnosis of cutaneous NK-/T-cell lymphoma was made. The patient was treated with alpha-interferon, valaciclovir hydrochloride, and low-dose prednisone for 2 months. Her skin lesions and lymphoadenopathy resolved initially, but she succumbed to the disease shortly after starting chemotherapy treatment 11 months later. To our knowledge, this is the first case of CD4+CD56+ NK-/T-cell lymphoma with clinical features resembling hydroa vacciniforme.

*Department of Dermatology, the Second Xiang Ya Hospital, Central South University, Changsha, China

Department of Dermatology, Yale University School of Medicine, New Haven, CT

Department of Pediatrics, Massachusettes General Hospital, Boston, MA.

Reprints: Rong Xiao, MD, PhD, Department of Dermatology, the Second Xiang Ya Hospital, 139 Ren Min Middle Rd, Central South University, Changsha 410011, China (e-mail:

The authors have no financial disclosures or conflicts of interest to declare.

G. Zhang and H. X. Bai contributed equally to this work.

© 2013 by Lippincott Williams & Wilkins.