Cutaneous T-Cell Lymphoma–Like Drug Eruption in an HIV-Positive Patient Taking Vancomycin and Rifampin

Abstract

Background:

Cutaneous T-cell pseudolymphoma (CTPL) is a benign reactive T-cell lymphoproliferative subtype of pseudolymphoma. Some variants of CTPL can resemble the plaques of mycosis fungoides (MF). The vast majority of drug-induced cases have been associated with anticonvulsants. There is only one report in the literature documenting a case of vancomycin-induced CTPL.

Methods:

We report a cutaneous T-cell lymphoma–like eruption in a human immunodeficiency virus (HIV)-positive patient recently started on vancomycin and rifampin.

Results:

A skin biopsy showed several histologic features of MF with immunohistochemical and T-cell receptor gene rearrangement studies suggestive of CTPL. This atypical T-cell reaction mimicking MF completely resolved on cessation of rifampin followed by vancomycin.

Conclusion:

Considering drug-induced causes of MF-like histologic changes is crucial to prevent unnecessary treatment for MF.