Dermatology Online Journal

Adult T cell leukemia/lymphoma (ATLL) is a rare, extremely aggressive malignancy with four different clinical variants, all of which are associated with human T cell lymphotropic virus type 1. Antiretrovirals have been recognized as an effective therapy after study in clinical trials around the world. However, oncologists traditionally wait for asymptomatic patients with ATLL to reach a more severe stage of disease before treatment is initiated. We describe a patient with Fitzpatrick Skin Type V who presented with asymptomatic dyschromia of her neck, breast, and jaw. Her clinical, laboratory, and histological findings were consistent with smoldering type-ATLL. We teamed up with her oncologist to successfully treat her cutaneous symptoms with interferon-alpha/zidovudine. This report demonstrates efficacy with the employment of antiretroviral therapy immediately following a diagnosis of smoldering type ATLL.