Photoaccentuated erythroderma associated with CD4 + T lymphocytopenia: Successful treatment with 5-methoxypsoralen and UVA, interferon alfa-2b, and extracorporeal photopheresis

We describe a 53-year-old HIV-negative white man who had chronic CD4 + T lymphocytopenia and photoaccentuated erythroderma with lymphoma-like histologic changes. The erythroderma completely responded to 5-methoxypsoralen and UVA (PUVA), interferon alfa-2b, and extracorporeal photopheresis. During therapy opportunistic skin infections, including tinea corporis, warts, and disseminated molluscum contagiosum, developed. Although the patient met the current definition of idiopathic CD4 + T lymphocytopenia (ICTL), we cannot rule out the possibility that his peripheral CD4 + T lymphocytopenia resulted from sequestration of CD4 + T lymphocytes in erythrodermic skin.