Adult T-Cell Lymphoma (ATL) With Erythroderma in Indolent Human T-Lymphotropic Virus Type I (HTLV-1) Infection

Adult T-cell lymphoma (ATL) is a hematological malignancy of CD4+ mature T-lymphocytes commonly associated with chronic human T-lymphotropic virus type I (HTLV-1) infection. Chronic HTLV-1 infection induces oncogenic mutations in CD4+ T-cells, leading to an acute malignant transformation of host cells. Atypically, ATL presents with dermatological and pulmonary symptoms consistent with a “smoldering” disease pattern. We present a case of a 78-year-old male patient with chronic generalized malaise, progressively worsening shortness of breath, and diffuse erythroderma, who was diagnosed with ATL secondary to chronic indolent HTLV-1 infection. We evaluate the multisystemic clinical signs associated with ATL, the comprehensive clinical investigations required to reach a conclusive diagnosis, and the options for long-term clinical management.