Eruption of lymphocyte recovery D89.-

Eruption of lymphocyte recovery" or "Cutaneous eruption of lymphocyte recovery" refers to an exanthematous, febrile "immune reconstitution syndrome" that can typically occur 1-3 weeks after aggressive myeloablative polychemotherapy.

Dei etiopathogenes is unclear. It is suspected that the exanthema occurs as an immunological reaction to the actual "return" of immunocompetent lymphocytes to the peripheral circulation or to the skin after aggressive, myoablative chemotherapy (Horn TDet al. 1989).

Erythematous or maculopapular, usually pruritic exanthema of the trunk and limbs. The exanthema is usually accompanied by fever. Underlying diseases are

acute myeloid leukaemia but also solid neoplasia. Erythrodermic findings have also been described.

Skin biopsies showed a dermal perivascular lymphocytic infiltrate with atypical medium to large CD3+, CD4+ and CD8+, CD25+, ICOS+, PD1 lymphocytes, most of which showed strong CD30 expression (Hurabielle Cet al. 2018).

Malignant CD30+ lymphoproliferative disorder (pseudo-Sézary syndrome)

An analogous immunological process known as "immune reconstitutional inflammatory syndrome" can also occur during HAART in the case of mostly advanced HIV infection (< 200 CD4 cells/µl; high HIV load). In this case, despite increasing T-helper cells, there is a temporary worsening of the disease state.

1. Friedler Set al. (1999) Atypical cutaneous lymphoproliferative disorder in patients with HIV infection. Int J Dermatol 38:111-118.
2. Horn TDet al (1989) Cutaneous eruptions of lymphocyte recovery. Arch Dermatol 125:1512-1517.
3. Hurabielle Cet al (2018) Eruption of lymphocyte recovery with atypical lymphocytes mimicking a primary cutaneous T-cell lymphoma: a series of 12 patients. Hum Pathol71:100-108.