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CD30+ T‐cell lymphoma in a patient with psoriasis treated with ciclosporin and infliximab

Summary There is a known relationship between the use of immunosuppressive therapies and the development of lymphoproliferative malignancies. These lymphomas are mainly B‐cell nonHodgkin's lymphomas associated with Epstein–Barr virus. Most cases concern classical immunosuppressive treatments including ciclosporin and methotrexate. A relationship between the new antitumour necrosis factor (TNF)‐α agents and lymphoproliferative malignancies is debated. Patients with psoriasis on immunosuppressive therapies, mainly ciclosporin, are considered to have a low risk of developing lymphoid proliferation. We report a patient with erythrodermic psoriasis treated with ciclosporin and infliximab who developed a CD30+ T‐cell lymphoma. This lymphoma regressed after stopping these treatments. In this case, the anti‐TNF‐α agent may have played a role in association with ciclosporin in the development of the lymphoproliferative disorder. Whereas the combination of anti‐TNF‐α therapies with methotrexate has been well studied, their combination with ciclosporin has been evaluated only in a few patients. Psoriatic patients who may require anti‐TNF‐α treatment have often been or will be treated with ciclosporin. The combination of ciclosporin and anti‐TNF‐α warrants further investigation.