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[Detection of clonal T-cell receptor gamma gene rearrangement with the use of PCR-DGGE for diagnosis of erythroderma].
Ann Dermatol Venereol. 2001 Mar; 128(3 Pt 1):220-3.AD

Abstract

BACKGROUND

It is often difficult to establish the etiological diagnosis of erythroderma because clinical findings and immunohistology cannot always distinguish between lymphomatous erythroderma and inflammatory erythroderma. The purpose of this work was to assess the contribution of PCR-DGGE for detecting clonal T-cell receptor gamma gene rearrangement to the etiological diagnosis of erythroderma.

PATIENTS AND METHODS

The following inclusion criteria were used: patient with erythroderma; skin biopsy for histologic study, immunophenotyping and molecular biology; minimal follow-up of 12 months after initial diagnosis. Thirty patients were included from May 1, 1995 to November 30, 1998. Histology slides were reread by one of the authors blinded to other data who classed them in three categories: probable lymphoma, probable inflammatory disease, uncertain diagnosis. Molecular data were also analyzed in the same blinded manner. Immunohistology diagnosis was compared with the molecular data and the final diagnosis retained from clinical, histological and molecular findings as well as the disease course to last follow-up (November 1, 1999) after a mean 12 +/- 18 months follow-up.

RESULTS

Eight biopsies were classed as probable lymphomas; a T-cell clonal rearrangement of the TCR genes was detected in 7/8 cases. The one sample with no detectable T clone was a drug-induced Sézary pseudolymphoma. The histologial classification identified 16 cases of probable inflammatory disease; no clonal rearrangement of the TCR genes was found in these cases. One of these patients had fungoid mycosis treated with caryolysin for three months and developed treatment intolerance at the time of the skin biopsy. For six biopsies the histological diagnosis was "uncertain"; a clonal rearrangement of the TCR genes was found in 2/3 of the fungoid mycosis cases and in none of the three cases of toxic dermal reactions.

DISCUSSION

This study demonstrated the contribution of genotypic analysis with PCR-DGGE to the diagnosis of erythroderma. Monoclonal TCR gene rearrangement was detected in 9/11 (82 p. 100) of the patients with lymphoma and in 0/19 of the patients with an inflammatory dermatosis. The etiological diagnosis of erythroderma is an excellent indication for molecular stud of skin biopsies with PCR-DGGE.

Authors+Show Affiliations

Clinique Dermatologique, Unité Inserm U519, Hôpital Charles Nicolle, 76031 Rouen Cedex, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

11319384

Citation

Cordel, N, et al. "[Detection of Clonal T-cell Receptor Gamma Gene Rearrangement With the Use of PCR-DGGE for Diagnosis of Erythroderma]." Annales De Dermatologie Et De Venereologie, vol. 128, no. 3 Pt 1, 2001, pp. 220-3.
Cordel N, Lenormand B, Courville P, et al. [Detection of clonal T-cell receptor gamma gene rearrangement with the use of PCR-DGGE for diagnosis of erythroderma]. Ann Dermatol Venereol. 2001;128(3 Pt 1):220-3.
Cordel, N., Lenormand, B., Courville, P., Lauret, P., & Joly, P. (2001). [Detection of clonal T-cell receptor gamma gene rearrangement with the use of PCR-DGGE for diagnosis of erythroderma]. Annales De Dermatologie Et De Venereologie, 128(3 Pt 1), 220-3.
Cordel N, et al. [Detection of Clonal T-cell Receptor Gamma Gene Rearrangement With the Use of PCR-DGGE for Diagnosis of Erythroderma]. Ann Dermatol Venereol. 2001;128(3 Pt 1):220-3. PubMed PMID: 11319384.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Detection of clonal T-cell receptor gamma gene rearrangement with the use of PCR-DGGE for diagnosis of erythroderma]. AU - Cordel,N, AU - Lenormand,B, AU - Courville,P, AU - Lauret,P, AU - Joly,P, PY - 2001/4/25/pubmed PY - 2001/8/31/medline PY - 2001/4/25/entrez SP - 220 EP - 3 JF - Annales de dermatologie et de venereologie JO - Ann Dermatol Venereol VL - 128 IS - 3 Pt 1 N2 - BACKGROUND: It is often difficult to establish the etiological diagnosis of erythroderma because clinical findings and immunohistology cannot always distinguish between lymphomatous erythroderma and inflammatory erythroderma. The purpose of this work was to assess the contribution of PCR-DGGE for detecting clonal T-cell receptor gamma gene rearrangement to the etiological diagnosis of erythroderma. PATIENTS AND METHODS: The following inclusion criteria were used: patient with erythroderma; skin biopsy for histologic study, immunophenotyping and molecular biology; minimal follow-up of 12 months after initial diagnosis. Thirty patients were included from May 1, 1995 to November 30, 1998. Histology slides were reread by one of the authors blinded to other data who classed them in three categories: probable lymphoma, probable inflammatory disease, uncertain diagnosis. Molecular data were also analyzed in the same blinded manner. Immunohistology diagnosis was compared with the molecular data and the final diagnosis retained from clinical, histological and molecular findings as well as the disease course to last follow-up (November 1, 1999) after a mean 12 +/- 18 months follow-up. RESULTS: Eight biopsies were classed as probable lymphomas; a T-cell clonal rearrangement of the TCR genes was detected in 7/8 cases. The one sample with no detectable T clone was a drug-induced Sézary pseudolymphoma. The histologial classification identified 16 cases of probable inflammatory disease; no clonal rearrangement of the TCR genes was found in these cases. One of these patients had fungoid mycosis treated with caryolysin for three months and developed treatment intolerance at the time of the skin biopsy. For six biopsies the histological diagnosis was "uncertain"; a clonal rearrangement of the TCR genes was found in 2/3 of the fungoid mycosis cases and in none of the three cases of toxic dermal reactions. DISCUSSION: This study demonstrated the contribution of genotypic analysis with PCR-DGGE to the diagnosis of erythroderma. Monoclonal TCR gene rearrangement was detected in 9/11 (82 p. 100) of the patients with lymphoma and in 0/19 of the patients with an inflammatory dermatosis. The etiological diagnosis of erythroderma is an excellent indication for molecular stud of skin biopsies with PCR-DGGE. SN - 0151-9638 UR - https://www.unboundmedicine.com/medline/citation/11319384/[Detection_of_clonal_T_cell_receptor_gamma_gene_rearrangement_with_the_use_of_PCR_DGGE_for_diagnosis_of_erythroderma]_ L2 - http://www.em-consulte.com/retrieve/pii/MDOI-ad-03-2001-128-3-0151-9638-101019-art5 DB - PRIME DP - Unbound Medicine ER -