{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T20:33:55Z","timestamp":1791146035038,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,1,18]],"date-time":"2014-01-18T00:00:00Z","timestamp":1390003200000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Adult <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>\u2010cell leukemia\/lymphoma (<jats:styled-content style=\"fixed-case\">ATLL<\/jats:styled-content>) is a malignancy of mature <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content> cells caused by human <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>\u2010cell leukemia virus type <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>. The endemic areas include <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>apan, especially in <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>yushu, the <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>aribbean, <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>apua <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>ew <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>uinea, <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>outh <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>merica and <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>frica. Approximately 50% of <jats:styled-content style=\"fixed-case\">ATLL<\/jats:styled-content> patients exhibit skin manifestations. Cytologically, <jats:styled-content style=\"fixed-case\">ATLL<\/jats:styled-content> tumor cells are characterized by <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4<jats:sup>+<\/jats:sup><jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>25<jats:sup>+<\/jats:sup> regulatory <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>\u2010cell phenotype, high expressions of <jats:styled-content style=\"fixed-case\">CCR<\/jats:styled-content>4, and programmed cell death (<jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>)\u20101 and <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>\u2010ligand 1. The skin eruptions are categorized into six types: patch, plaque, multipapular, nodulotumoral, erythrodermic and purpuric. The overall survival of the eruption\u2010bearing patients was poorer than that of the non\u2010eruption\u2010bearing patients in acute, chronic and smoldering types, but the survival levels of both groups were comparable in lymphoma type. The prognosis was poor in the order of: erythrodermic, nodulotumoral, multipapular\/purpuric, plaque, then patch. Multivariate analysis revealed that the eruption type is an independent prognostic factor for <jats:styled-content style=\"fixed-case\">ATLL<\/jats:styled-content>. Patients may have other skin manifestations, secondary and infective lesions.<\/jats:p>","DOI":"10.1111\/1346-8138.12328","type":"journal-article","created":{"date-parts":[[2014,1,18]],"date-time":"2014-01-18T13:16:47Z","timestamp":1390051007000},"page":"19-25","source":"Crossref","is-referenced-by-count":55,"title":["Skin manifestations of adult T\u2010cell leukemia\/lymphoma: Clinical, cytological and immunological features"],"prefix":"10.1111","volume":"41","author":[{"given":"Yoshiki","family":"Tokura","sequence":"first","affiliation":[{"name":"Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Sawada","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Occupational and Environmental Health Kitakyushu 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