Monoclonal rearrangement of the T cell receptor gamma-chain in lichenoid pigmented purpuric dermatitis of gougerot-blum responding to topical corticosteroid therapy

• Published in: Dermatology (Basel) Vol. 205; no. 2; p. 191
• Main Authors: Lor, P, Krueger, U, Kempf, W, Burg, G, Nestle, F O
• Format: Journal Article
• Language: English
• Published: Switzerland 01-01-2002
• Subjects: Administration, Topical; Aged; Anti-Inflammatory Agents - therapeutic use; Clobetasol - analogs & derivatives; Clobetasol - therapeutic use; Clone Cells; Electrophoresis; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor; Glucocorticoids; Humans; Lichenoid Eruptions - drug therapy; Lichenoid Eruptions - genetics; Lichenoid Eruptions - immunology; Lichenoid Eruptions - pathology; Male; Pigmentation Disorders - drug therapy; Pigmentation Disorders - genetics; Pigmentation Disorders - immunology; Pigmentation Disorders - pathology; Polymerase Chain Reaction; Purpura - drug therapy; Purpura - genetics; Purpura - immunology; Purpura - pathology; Skin - pathology
• ISSN: 1018-8665
• DOI: 10.1159/000063912

Lichenoid pigmented purpuric dermatitis of Gougerot-Blum belongs to a group of closely related disorders which are termed pigmented purpuric dermatoses. It clinically manifests itself with grouped lichenoid papules in association with purpuric lesions. We report a case of lichenoid pigmented purpuric dermatitis of Gougerot-Blum with a heavy band-like CD4-positive lymphocytic infiltrate and clonal rearrangements of the gamma-chain of the T cell receptors as detected by polymerase chain reaction/denaturing gradient gel electrophoresis. Monoclonal expansion of T cells in combination with certain histological features of mycosis fungoides (MF) might support a biological relationship between lichenoid pigmented purpuric dermatitis of Gougerot-Blum and MF. However, prompt clinical response to topical steroid therapy supports the benign clinical nature of our case.