{"id":1463,"date":"2026-05-04T20:19:43","date_gmt":"2026-05-04T18:19:43","guid":{"rendered":"https:\/\/epilogy.org\/?p=1463"},"modified":"2026-05-04T21:02:54","modified_gmt":"2026-05-04T19:02:54","slug":"severe-ulceronecrotic-evolution-during-mogamulizumab-treatment-in-a-patient-with-primary-cutaneous-peripheral-t-cell-lymphoma","status":"publish","type":"post","link":"https:\/\/epilogy.org\/fr\/severe-ulceronecrotic-evolution-during-mogamulizumab-treatment-in-a-patient-with-primary-cutaneous-peripheral-t-cell-lymphoma","title":{"rendered":"\u00c9volution ulc\u00e9ro-n\u00e9crotique s\u00e9v\u00e8re sous traitement par mogamulizumab chez un patient atteint d\u2019un lymphome T p\u00e9riph\u00e9rique cutan\u00e9 primitif"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"1463\" class=\"elementor elementor-1463\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c5646aa e-flex e-con-boxed e-con e-parent\" data-id=\"c5646aa\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e35e7ec elementor-widget elementor-widget-html\" data-id=\"e35e7ec\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t\t<style>\n.epilogy-accordion{\nbackground:#ffffff;\nborder:1px solid #ead3ee;\nborder-radius:8px;\npadding:20px;\nmargin:24px 0;\nfont-size:13px;\ncolor:#54595F;\nline-height:1.7;\nbox-shadow:0 2px 8px rgba(0,0,0,0.04);\n}\n\n.epilogy-accordion details{\nborder-top:1px solid #eee;\npadding:10px 0;\n}\n\n.epilogy-accordion details:first-of-type{\nborder-top:none;\n}\n\n.epilogy-accordion summary{\ncursor:pointer;\nfont-weight:600;\ncolor:#7C2A86;\nfont-size:13px;\nlist-style:none;\nposition:relative;\npadding-left:18px;\n}\n\n.epilogy-accordion summary::before{\ncontent:\"+\";\nposition:absolute;\nleft:0;\ntop:0;\n}\n\n.epilogy-accordion details[open] summary::before{\ncontent:\"\u2013\";\n}\n\n.epilogy-highlight{\nbackground:#FADFFF;\npadding:14px;\nborder-radius:6px;\nmargin-top:18px;\nfont-size:13px;\nborder-left:4px solid #7C2A86;\n}\n\n.epilogy-highlight h3{\nmargin:0 0 6px 0;\ncolor:#7C2A86;\nfont-size:13px;\n}\n\n.epilogy-highlight a{\nfont-size:12px;\nopacity:0.9;\n}\n\n.epilogy-authors{\nmargin-top:20px;\npadding-top:14px;\nborder-top:1px solid #eee;\n}\n\n.epilogy-authors-title{\nfont-weight:600;\ncolor:#7C2A86;\nmargin-bottom:10px;\n}\n\n.epilogy-authors-grid{\ndisplay:grid;\ngrid-template-columns:repeat(3,1fr);\ngap:10px;\ntext-align:center;\njustify-items:center;\n}\n\n.epilogy-authors-grid img{\nwidth:70px;\nheight:70px;\nobject-fit:cover;\nborder-radius:100%;\ntransition:all .2s ease;\n}\n\n.epilogy-authors-grid span{\ndisplay:block;\nmargin-top:6px;\nfont-size:12px;\n}\n<\/style>\n\n<div class=\"epilogy-accordion\">\n\n<details open>\n<summary>Background<\/summary>\n<p>\nMogamulizumab, an anti-CCR4 monoclonal antibody, is currently registered in the treatment of primary cutaneous T-cell lymphomas (Mycosis Fungoides and S\u00e9zary Syndrome). Its approval was based on the MAVORIC phase III trial, showing significantly improved progression-free survival compared with vorinostat. Drug-induced eruptions are reported as \u201cvery common\u201d in the Summary of Product Characteristics (SmPC), but with no mention of ulceronecrotic evolution of skin lesions. We hereby report a case of severe ulceronecrotic evolution occurring during mogamulizumab in a patient with primary cutaneous peripheral T-cell lymphoma not otherwise specified (pcPTCL-NOS).\n<\/p>\n<\/details>\n\n<details>\n<summary>Objectives<\/summary>\n<p>\nTo report a severe and previously undescribed ulceronecrotic evolution of cutaneous lymphoma lesions under mogamulizumab and to discuss potential mechanisms and pharmacovigilance signals.\n<\/p>\n<\/details>\n\n<details>\n<summary>Methods<\/summary>\n<p>\nA 55-year-old man was followed for nodular skin lesions of vascular appearance, predominantly affecting the lower limbs, evolving over several years without extracutaneous involvement. Histology repeatedly showed an atypical CD3+CD4+CD7- CD30- lymphocytic infiltrate with a dominant cutaneous T-cell clone and vascular component, consistent with pcPTCL-NOS. Multiple systemic therapies were administered sequentially (methotrexate, liposomal pegylated doxorubicin, pegylated interferon, bendamustine) with limited efficacy or significant toxicity. Mogamulizumab was introduced as fifth-line therapy (1 mg\/kg weekly \u00d74, then every 2 weeks) based on CCR4 expression.\n<\/p>\n<p>\n<img decoding=\"async\" src=\"https:\/\/cdn.ncbi.nlm.nih.gov\/pmc\/blobs\/4e41\/13094340\/e9e9e6ac85e7\/ActaDv-106-0279.f001.jpg\" style=\"max-width:100%; border-radius:6px;\">\n<span style=\"display:block; font-size:11px; margin-top:6px;\">Fig. 1. Tumoural lesions at initiation of mogamulizumab.<\/span>\n<\/p>\n<\/details>\n\n<details>\n<summary>Results<\/summary>\n<p>\nFrom day 3 after the first infusion, some nodules evolved toward painful ulceronecrotic lesions, while others remained stable or progressed. No systemic symptoms were observed. The condition worsened over weeks, leading to discontinuation after 8 infusions. Two months later, ulcerations persisted, some requiring skin grafting. Subsequent BV-CHP therapy led to progressive re-epithelialization and tumour flattening.\n<\/p>\n<p>\n<img decoding=\"async\" src=\"https:\/\/cdn.ncbi.nlm.nih.gov\/pmc\/blobs\/4e41\/13094340\/eb51cb4e7cb8\/ActaDv-106-0279.f002.jpg\" style=\"max-width:100%; border-radius:6px;\">\n<span style=\"display:block; font-size:11px; margin-top:6px;\">Fig. 2. Ulceronecrotic evolution 6 weeks after last infusion.<\/span>\n<\/p>\n<\/details>\n\n<details>\n<summary>Conclusion<\/summary>\n<p>\nMogamulizumab-associated rashes are usually benign and non-necrotic. However, this case suggests a rare but severe ulceronecrotic evolution. Pharmacovigilance data (VigiBase) identify similar events, although causality remains difficult to establish. Possible mechanisms include immune dysregulation via T-reg depletion, autoantibody formation, or direct cytotoxicity in CCR4-expressing lesions. Close and prolonged clinical monitoring is essential in such patients.\n<\/p>\n<p>\nAs with any pharmacovigilance database, establishing a causal relationship between a reported adverse event and a suspected drug remains challenging. The conclusions derived from VigiBase do not represent the opinions of the WHO or affiliated institutions.\n<\/p>\n<\/details>\n\n<div class=\"epilogy-authors\">\n<div class=\"epilogy-authors-title\">Epilogy team author<\/div>\n\n<div class=\"epilogy-authors-grid\">\n<div>\n<img decoding=\"async\" src=\"https:\/\/epilogy.org\/wp-content\/uploads\/2026\/03\/Quentin_Samaran.jpg\">\n<span>Quentin Samaran<\/span>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"epilogy-highlight\">\n<h3>Severe Ulceronecrotic Evolution during Mogamulizumab Treatment in a Patient with Primary Cutaneous Peripheral T-cell Lymphoma<\/h3>\n<p style=\"margin:0;\">\n<a href=\"https:\/\/doi.org\/10.2340\/actadv.v106.adv-2025-0279\" target=\"_blank\">\nhttps:\/\/doi.org\/10.2340\/actadv.v106.adv-2025-0279\n<\/a>\n<\/p>\n<\/div>\n\n<\/div>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Background Mogamulizumab, an anti-CCR4 monoclonal antibody, is currently registered in the treatment of primary cutaneous T-cell lymphomas (Mycosis Fungoides and S\u00e9zary Syndrome). Its approval was based on the MAVORIC phase III trial, showing significantly improved progression-free survival compared with vorinostat. Drug-induced eruptions are reported as \u201cvery common\u201d in the Summary of Product Characteristics (SmPC), but&hellip;&nbsp;<a href=\"https:\/\/epilogy.org\/fr\/severe-ulceronecrotic-evolution-during-mogamulizumab-treatment-in-a-patient-with-primary-cutaneous-peripheral-t-cell-lymphoma\" rel=\"bookmark\"><span class=\"screen-reader-text\">\u00c9volution ulc\u00e9ro-n\u00e9crotique s\u00e9v\u00e8re sous traitement par mogamulizumab chez un patient atteint d\u2019un lymphome T p\u00e9riph\u00e9rique cutan\u00e9 primitif<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":1469,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":70,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","neve_meta_reading_time":"","footnotes":""},"categories":[1,18,20],"tags":[],"class_list":["post-1463","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-epilogy","category-epinews","category-last-publications"],"_links":{"self":[{"href":"https:\/\/epilogy.org\/fr\/wp-json\/wp\/v2\/posts\/1463","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/epilogy.org\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/epilogy.org\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/epilogy.org\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/epilogy.org\/fr\/wp-json\/wp\/v2\/comments?post=1463"}],"version-history":[{"count":5,"href":"https:\/\/epilogy.org\/fr\/wp-json\/wp\/v2\/posts\/1463\/revisions"}],"predecessor-version":[{"id":1470,"href":"https:\/\/epilogy.org\/fr\/wp-json\/wp\/v2\/posts\/1463\/revisions\/1470"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/epilogy.org\/fr\/wp-json\/wp\/v2\/media\/1469"}],"wp:attachment":[{"href":"https:\/\/epilogy.org\/fr\/wp-json\/wp\/v2\/media?parent=1463"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/epilogy.org\/fr\/wp-json\/wp\/v2\/categories?post=1463"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/epilogy.org\/fr\/wp-json\/wp\/v2\/tags?post=1463"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}