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Örnek S, Ozekinci S, Ipin T, Kocaturk E. TOX, TWIST1, STAT4, and SATB1 protein expressions in early-stage mycosis fungoides. J Cutan Pathol 2024; 51:232-238. [PMID: 37932931 DOI: 10.1111/cup.14557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Diagnosis of early mycosis fungoides (eMF) is challenging and often delayed as many of its clinical and histopathologic features may mimic various benign inflammatory dermatoses (BIDs). The products of the thymocyte selection-associated high mobility group box (TOX), twist family BHLH transcription factor 1 (TWIST1), signal transducer and activator of transcription 4 (STAT4), and special AT-rich sequence-binding protein 1 (SATB1) genes function as transcription factors and are involved in the pathogenesis of MF. OBJECTIVES We aim to determine the diagnostic value of TOX, TWIST1, STAT4, and SATB1 protein expressions in eMF. METHODS This non-randomized, controlled, prospective analytic study was conducted by performing immunohistochemistry staining with TOX, TWIST1, STAT4, and SATB1 polyclonal antibodies in lesional skin biopsies of eMF and BID patients. Nuclear staining of lymphocytes was compared between eMF and BIDs, and the capacity of these antibodies to predict eMF was determined. RESULTS Immunostainings with anti-TWIST1 showed an increase in protein expression (p = 0.003) and showed a decrease with anti-SATB1 antibodies in eMF compared to BIDs (p = 0.005) while anti-TOX and anti-STAT4 antibodies did not exhibit significant differences (p = 0.384; p = 0.150). Receiver operating characteristic analysis showed that immunohistochemical evaluations of TWIST1 and SATB1 protein expressions can differentiate eMF (area under the curve [AUC]: 0.728, 95% confidence interval [CI]: 0.605-0.851, p = 0.002; AUC: 0.686, 95% CI: 0.565-0.807, p = 0.013). CONCLUSIONS TWIST1 and SATB1 are potential diagnostic markers for the histologic diagnosis of eMF.
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Affiliation(s)
- Sinem Örnek
- Department of Dermatology, Health Sciences University Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selver Ozekinci
- Department of Pathology, Dicle University Hospital, Diyarbakir, Turkey
| | - Tugba Ipin
- Department of Pathology, Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Emek Kocaturk
- Department of Dermatology, Koc University School of Medicine, Istanbul, Turkey
- Institute of Allergy, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Kashabano JJ, Rugengamazi E, Matiku SB, Mruma RM, Lugina EL. Mycosis fungoides with spongiosis: a case report. J Med Case Rep 2023; 17:458. [PMID: 37919795 PMCID: PMC10623773 DOI: 10.1186/s13256-023-04188-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/20/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma (CTCL). CTCL are an uncommon, heterogeneous group of non-Hodgkin lymphomas (NHLs) of T- and B-cell origin where the skin is the primary organ of involvement. It is characterized by malignant CD4+ T-cells infiltrating the skin and other organs, leading to progressive skin and systemic involvement. Histopathologically, MF is characterized by atypical lymphocytes demonstrating epidermotropism without spongiosis. Spongiosis is the histological hallmark of intercellular epidermal edema, viewed as clear spaces within the epidermis, and is very common in benign inflammatory dermatoses. Very few studies have reported MF in sub-Saharan Africa (SSA). We are reporting a case of MF with a rare presentation of spongiosis treated successfully with a low dose total skin electron beam therapy (TSEBT) followed by maintenance therapy of low dose Methotrexate (MT) at the Ocean Road Cancer Institute (ORCI) in Tanzania. This is the first case of MF to be managed with low-dose TSEBT in Tanzania. The authors wish to create awareness of the disease among physicians and pathologists and expand on the data paucity in SSA. CASE DESCRIPTION We are reporting a case of a 31-year-old male of African origin who self-referred to our oncology center with a 4-year history of skin rashes throughout the body, which was unresponsive to topical steroid treatment. The biopsy was taken, and the patient was diagnosed with MF CD 3 positive with spongiosis. The patient was treated with radiotherapy, whereby he received low dose total skin electron beam therapy (TSEBT) 12 Gy in 3 fractions at a daily dose of 4 Gy, followed by maintenance therapy of low dose Methotrexate and attained an excellent therapeutic response. CONCLUSION Spongiosis is an infrequent presentation of MF. Low-dose TSEBT provides reliable and rapid reduction of disease burden in patients with MF, which could be administered safely multiple times during a patient's disease with an acceptable toxicity profile. Lack of tendency to perform skin biopsies and cost constraints in assessing multiple immunophenotypic markers lead to missing the diagnosis. Diagnosis and treatment of MF in resource-limited countries is challenging.
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Affiliation(s)
- Jesse Jonathan Kashabano
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.
- Benjamin Mkapa Hospital, Dodoma, Tanzania.
| | - Eulade Rugengamazi
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Subira Bhoke Matiku
- Department of Pathology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Rashid Mussa Mruma
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
- Ocean Road Cancer Institute, Dar Es Salaam, Tanzania
| | - Emmanuel L Lugina
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
- Ocean Road Cancer Institute, Dar Es Salaam, Tanzania
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Kaiser M, Abdin R, Yaghi M, Gaumond SI, Jimenez JJ, Issa NT. Beard Alopecia: An Updated and Comprehensive Review of Etiologies, Presentation and Treatment. J Clin Med 2023; 12:4793. [PMID: 37510908 PMCID: PMC10381635 DOI: 10.3390/jcm12144793] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
Facial hair is an important social and psychologic aspect of clinical appearance for men. The purpose of this review is to provide a comprehensive overview of the causes of alopecia of the beard including the prevalence, pathophysiology, clinical presentation, and treatment. In this review, we highlight more common causes of beard alopecia including alopecia areata and pseudofolliculitis barbae, infectious causes such as tinea barbae and herpes simplex folliculitis, and rare causes including dermatopathia pigmentosa reticularis and frontal fibrosing alopecia. This review serves as an important resource for clinicians when faced with patients suffering from beard alopecia.
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Affiliation(s)
- Michael Kaiser
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Rama Abdin
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA
| | - Marita Yaghi
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Simonetta I Gaumond
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Joaquin J Jimenez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Naiem T Issa
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Forefront Dermatology, Vienna, VA 22182, USA
- Issa Research and Consulting, LLC, Springfield, VA 22152, USA
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4
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Beyzaee AM, Jahantigh N, Goldust M, Rahmatpour Rokni G, Babaei M, Ghoreishi B, Sadathosseini S. Mycosis fungoides with Psoriasiform plaques: A case report and review of the literature. Clin Case Rep 2023; 11:e6848. [PMID: 36846176 PMCID: PMC9950353 DOI: 10.1002/ccr3.6848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 02/27/2023] Open
Abstract
Mycosis fungoides (MF) is the most common variant of primary skin T-cell lymphoma. It typically manifests as an indolent progressing cutaneous eruption with erythematous scaly patches or plaques. Due to the nonspecific pathological findings, it can be easily misdiagnosed as psoriasis. A 34-year-old woman with a history of psoriasiform plaques for 12 years was referred to our dermatology clinic. In the beginning, the diagnosis of psoriasis was made and topical steroids were prescribed: it did not exhibit any clinical improvement. During the visit, skin biopsy was performed and the diagnosis of MF was confirmed. Treatment with PUVA, prednisolon, methotrexate, topical ointment including ucerin, urea, and clobetasol were initiated. Significant improvement in all lesions were observed after 1 month of the treatment, and within a year, the disease improved dramatically after PUVA therapy. In refractory cases of psoriasiform plaques that are progressive and/or ulcerative despite the optimal treatment, biopsy is required and a possible diagnosis of MF should be kept in mind.
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Affiliation(s)
| | | | - Mohammad Goldust
- Department of DermatologyUniversity Medical Center MainzMainzGermany
| | - Ghasem Rahmatpour Rokni
- Department of Dermatology, Faculty of MedicineMazandaran University of Medical SciencesSariIran
| | - Mahsa Babaei
- Shahid Beheshti University of Medical SciencesTehranIran
| | - Bahare Ghoreishi
- Department of DermatologyMazandaran University of Medical SciencesSariIran
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Fki A, Kotti N, Dhouib F, Kammoun N, Frikha M, Jmal Hammami K, Masmoudi M, Turki H, Hajjaji M. Les facteurs professionnels associés au mycosis fongoïde. ARCH MAL PROF ENVIRO 2022. [DOI: 10.1016/j.admp.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lombardi CV, Glosser LD, Hopper W, Veria S, Awad MT, Garg A. Erythrodermic mycosis fungoides with large cell transformation: An unusual and complicated case. SAGE Open Med Case Rep 2022; 10:2050313X221131163. [PMID: 36313267 PMCID: PMC9608024 DOI: 10.1177/2050313x221131163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Mycosis fungoides is the most common cutaneous T-cell lymphoma. It presents a diagnostic challenge due to resemblance with many other dermatologic conditions. The disease typically follows a progression from patches to plaques to skin-based tumors with potential for visceral involvement. Diagnosis is made by clinical presentation and histology. When early diagnosis is made, there is an estimated 88% five-year survival. This report details a 60-year-old Black man diagnosed with stage IIIA mycosis fungoides with a severe degree of cutaneous involvement. This case is unique due to the aggressive large cell transformation and rapid progression to death within 18 months of diagnosis. We highlight the challenge of diagnosing, treating, and monitoring the therapeutic response of mycosis fungoides. Finally, this case calls for a multi-disciplinary approach to treatment and to include mycosis fungoides on the differential diagnosis for patients presenting with a variety of vague, recurrent cutaneous symptoms, especially with patchy dyspigmentation or plaques.
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Affiliation(s)
- Conner V Lombardi
- College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA,Conner V Lombardi, College of Medicine and Life Sciences, The University of Toledo, 3000 Arlington Avenue, Toledo, OH 43614, USA.
| | - Logan D Glosser
- College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA
| | - Wade Hopper
- Edward via College of Osteopathic Medicine, Spartanburg, SC, USA
| | - Spiro Veria
- College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA
| | - Mohammed T Awad
- Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USA
| | - Anu Garg
- Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USA
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Polgárová K, Polívka J, Kodet O, Klener P, Trněný M. Retrospective Analysis of 118 Patients With Cutaneous T-Cell Lymphomas: A Single-Center Experience. Front Oncol 2022; 12:884091. [PMID: 35747818 PMCID: PMC9210166 DOI: 10.3389/fonc.2022.884091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/18/2022] [Indexed: 11/18/2022] Open
Abstract
Cutaneous T-cell lymphomas (CTCL) represent rare non-Hodgkin lymphomas (NHL) with an incidence less than 1 per 100,000 inhabitants. The most common type of CTCL is mycosis fungoides (MF), which represents approximately 60% of all CTCL, followed by Sézary syndrome (SS), approximately 5%. We retrospectively analyzed the outcome of 118 patients with MF (n=96) and SS (n=22) treated between the years 1998 and 2021 at the Charles University General Hospital in Prague, Czech Republic. The ratio between men and women was 1.2:1 (62 men, and 56 women). The median age at diagnosis was 62 years (23 to 92 years). From the MF cohort 48 patients (50% out of MF cohort) presented with advanced stage disease. Ninety patients (77%) received a systemic treatment at any time from the diagnosis; the median number of therapy lines was two. At the time of database lock, the overall survival (OS) of 96 patients with MF reached 17.7 years with the median follow-up 4.0 years. With the median follow-up 2.6 years, the median OS of 22 patients with SS was 3.5 years. The most common type of systemic therapy for MF included low-dose methotrexate (61%), interferon-alpha (58%), bexarotene (28%), and chlorambucil (25%). The most common type of therapy for SS included bexarotene (64%), extracorporeal photopheresis (50%), and interferon-alpha (45%). Only the minority of patients received innovative targeted agents including brentuximab vedotin, mogamulizumab, or pembrolizumab. Besides the retrospective analysis of the CTCL cohort, current standards and future perspectives of selected innovative agents are summarized and discussed. The analyzed cohort represents the largest cohort of CTCL patients in the Czech Republic. Overall, the survival parameters of our CTCL cohort are comparable to those previously published by other groups. In conclusion, our analysis of 118 real world cohort of consecutive CTCL patients treated at the single center confirmed the efficacy of immune response modifiers and underlines the urgent need for ample implementation of innovative agents and their combinations into earlier lines of therapy.
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Affiliation(s)
- Kamila Polgárová
- First Dept. of Internal Medicine - Hematology, University General Hospital in Prague and First Faculty of Medicine, Charles University, Prague, Czechia
| | | | - Ondřej Kodet
- Department of Dermatovenerology, University General Hospital in Prague and First Faculty of Medicine, Charles University, Prague, Czechia
| | - Pavel Klener
- First Dept. of Internal Medicine - Hematology, University General Hospital in Prague and First Faculty of Medicine, Charles University, Prague, Czechia
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czechia
- *Correspondence: Pavel Klener,
| | - Marek Trněný
- First Dept. of Internal Medicine - Hematology, University General Hospital in Prague and First Faculty of Medicine, Charles University, Prague, Czechia
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Banciu ML, Dobrica EC, Soare C, Malciu AM, Voiculescu VM. Healthcare Disparities in the Management of Indolent Mycosis Fungoides. Cureus 2022; 14:e24098. [PMID: 35573524 PMCID: PMC9106548 DOI: 10.7759/cureus.24098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/18/2022] Open
Abstract
Mycosis fungoides represents the most common cutaneous T-cell lymphoma, clinically manifested with evolving skin lesions, including patches, plaques, tumors, and erythroderma. Early diagnosis remains difficult to establish because it mimics several benign skin conditions, but maintaining a high index of suspicion for the disease is essential in preventing the progression of a potentially fatal disease. We report the case of a 69-year-old female who presented in our dermatology clinic in 2018 with scaly, indurated, itchy erythematous-violaceus patches and plaques, and tumors disseminated throughout the skin evolving for nine years. Skin biopsy supplemented with immunohistochemical staining established the diagnosis of mycosis fungoides. Due to the equivocal clinical presentation and the lack of extracutaneous manifestations, the patient received conventional therapy according to the stage of the disease. The rapidly progressive evolution of the cutaneous lesions in the last year of the disease determined the patient’s death despite instituting systemic chemotherapy. Patient follow-up and a multidisciplinary approach are essential to diagnose and manage this disease in its early stages. This will prevent the progression to a life-threatening malignancy and the use of immunosuppressive therapy, which can cause serious side effects.
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Bayramgürler D, Kazan D, Eruyar T, Demirkesen C, Demirbaş A. The oral cavity and gastric involvement in mycosis fungoides while on systemic bexarotene therapy: A rare case report. Dermatol Ther 2022; 35:e15349. [PMID: 35103368 DOI: 10.1111/dth.15349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 01/28/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Dilek Bayramgürler
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Didem Kazan
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Tuğrul Eruyar
- Department of Pathology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Cüyan Demirkesen
- Department of Pathology, Faculty of Medicine, Acıbadem University, İstanbul, Turkey
| | - Abdullah Demirbaş
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
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Schukow CP, Schaeffer M, Boss K, Fivenson D. Management of a Unique Presentation of a Common Dermatologic Condition. Spartan Med Res J 2021; 6:24501. [PMID: 34589664 PMCID: PMC8405279 DOI: 10.51894/001c.24501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/01/2021] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Skin rashes are a common complaint seen in the primary care setting. There are many dermatologic conditions which a primary care provider (PCP) should be able to recognize and manage. One such condition is granuloma annulare (GA), which commonly presents as smooth, annular plaques on the trunk and/or extremities. Rashes like GA rarely present as unique variants and may be difficult for PCPs to determine from patient history and physical exam alone. Patch granuloma annulare (patch GA) is an example that may clinically mimic a cutaneous lymphoma known as mycosis fungoides (MF). PCPs should ideally be able to recognize the utility of performing a skin biopsy and/or referring the patient to a dermatologist when history and physical exam alone are insufficient. The histologic findings of skin biopsies often become essential in establishing a proper diagnosis and guiding patient management in unique dermatologic variants. EXAMPLE CASE The patient in this clinical practice report is a Caucasian female in her late 60s who presented to a dermatology clinic with a two-year history of a worsening widespread eruption on her trunk and extremities. She had been evaluated previously by her PCP about 4 months prior and, without obtaining skin biopsies, treated her with a medium potency topical corticosteroid cream. The eruption had spread over her hips, buttocks, back, thighs, wrists, and elbows. Multiple skin biopsies of affected sites were taken by the second author and revealed findings consistent with patch GA. The patient was started on topical betamethasone dipropionate 0.05% ointment twice daily and noted marked improvement of her symptoms. CONCLUSIONS Although GA is a benign condition of the skin that may be readily detected by PCPs, skin biopsies may be necessary to establish a proper diagnosis when this condition presents as a unique variant (e.g., patch GA). Therapy for patch GA often begins with a trial of high-potency topical steroid therapy in combination with ultraviolet light exposure, depending on disease severity and patient preference. Early evaluation with a skin biopsy by her PCP or an earlier referral to a dermatologist to have skin biopsies performed likely would have helped establish a prompter diagnosis and treatment plan for this patient.
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Affiliation(s)
| | | | - Katherine Boss
- Michigan State University College of Osteopathic Medicine
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Martínez-Rodríguez M, Monteagudo C. CCL27 Signaling in the Tumor Microenvironment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1302:113-132. [PMID: 34286445 DOI: 10.1007/978-3-030-62658-7_9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chemokines are a group of small proteins which play an important role in leukocyte migration and invasion. They are also involved in the cellular proliferation and migration of tumor cells.Chemokine CCL27 (cutaneous T cell-attracting chemokine, CTACK) is mainly expressed by keratinocytes of the normal epidermis. It is well known that this chemokine plays an important role in several inflammatory diseases of the skin, such as atopic dermatitis, contact dermatitis, and psoriasis. Moreover, several studies have shown an association between CCL27 expression and a variety of neoplasms including skin cancer.In this chapter, we address the role of chemokine CCL27 in the tumor microenvironment in the most relevant cancers of the skin and other anatomical locations. We also make a brief comment on future perspectives and the potential relation of CCL27 with different immunotherapeutic modalities.
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Affiliation(s)
| | - Carlos Monteagudo
- Department of Pathology, University Clinic Hospital-INCLIVA, University of Valencia, Valencia, Spain.
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Ding X, Chen J, Kuai L, Xing M, Ru Y, Luo Y, Luo Y, Zhou M, Li B, Li X. CD4/CD8 dual-positive mycosis fungoides: A case report and literature review. Medicine (Baltimore) 2020; 99:e22786. [PMID: 33080750 PMCID: PMC7571916 DOI: 10.1097/md.0000000000022786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma. It appears as patches, plaques, and tumors depending on the stage of the disease, which presents a chronic progressive course. Compared to CD4/CD8 MF, CD4/CD8 dual-positive MF is an uncommon immune phenotype. PATIENT CONCERNS A 36-year-old male patient presented with dryness and scales on his whole body. DIAGNOSIS The patient was diagnosed with MF based on results of pathological examination, immunohistochemical staining, and T-cell receptor gene rearrangement test. INTERVENTIONS The patient was advised to take an herbal medicine orally twice daily and apply a topical moisturizer after showering. OUTCOMES After treatment and follow-up, the patient's symptoms of dryness and scales improved and his condition stabilized. CONCLUSIONS While reviewing the literature, we found no previous reports on the treatment of dual-positive MF with Chinese medicine. In this report, we presented the first case of dual-positive MF successfully treated with Chinese medicine. The results suggest that oral ingestion of herbal medicine may be a feasible method for alleviating clinical symptoms of early stage MF. Therefore, the therapy should be explored for clinical use in the future.
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Affiliation(s)
- Xiaojie Ding
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
| | - Jia Chen
- Department of Dermatopathology, Shanghai Dermatology Hospital, Tongji University
| | - Le Kuai
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
| | - Meng Xing
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
| | - Yi Ru
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Ying Luo
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Yue Luo
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
| | - Mi Zhou
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
| | - Bin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
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13
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Scali E, Presta I, Donato A, Schipani G, Dastoli S, Rossi M, Mignogna C, Malara N, Nisticò SP, Donato G. Mycosis fungoides and gastric T-cell lymphoma: A case report. Mol Clin Oncol 2020; 13:15. [PMID: 32754329 PMCID: PMC7391825 DOI: 10.3892/mco.2020.2085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 05/19/2020] [Indexed: 11/16/2022] Open
Abstract
Mycosis fungoides (MF) is a cutaneous malignant lymphoma with an extended clinical course. MF presents in series of dermatological manifestations, beginning with patches and plaques of the skin, and eventually evolving into tumours. Often MF can occur for extended periods without worsening of external symptoms, while the disease advances internally in organs such as lymph nodes, liver, spleen, lung, bone marrow, gastrointestinal tract, pancreas and kidney. The present report presents a clinical case in which gastrointestinal symptomatology occurred a decade after the first dermatological manifestation. Immunohistochemical analysis of the skin, along with small bowel biopsies revealed evidence of gastric T-cell lymphoma. To the best of our knowledge, the present study is the first to describe such a case in the literature.
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Affiliation(s)
- Elisabetta Scali
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Ivan Presta
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Annalidia Donato
- Department of Medical and Surgical Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Giusy Schipani
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Stefano Dastoli
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Marco Rossi
- Department of Clinical and Experimental Medicine, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Chiara Mignogna
- Department of Interdipartimental Services Center (CIS), University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Natalia Malara
- Department of Clinical and Experimental Medicine, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Steven Paul Nisticò
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Giuseppe Donato
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
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Baykal C, Atci T, Buyukbabani N, Kutlay A. The Spectrum of Underlying Causes of Iatrogenic Kaposi's Sarcoma in a Large Series: A Retrospective Study. Indian J Dermatol 2019; 64:392-399. [PMID: 31543535 PMCID: PMC6749761 DOI: 10.4103/ijd.ijd_217_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: The frequency of clinicoepidemiological variants of Kaposi's sarcoma (KS) differs markedly throughout the world. The iatrogenic variant is mainly associated with the use of immunosuppressive therapy. Aims: We aimed to investigate the distribution of KS variants in our practice and elucidate the underlying causes of iatrogenic KS. Methods: Consecutive KS patients seen in a single tertiary center were grouped according to the tumor variants and iatrogenic KS patients were evaluated about associated conditions. Results: Among 137 patients, classic variant was the most frequent presentation (n = 88), followed by iatrogenic (n = 37) variant. Among the iatrogenic group, ten were transplant recipients. In 16 iatrogenic KS patients, systemic corticosteroid was used, in four for myasthenia gravis (MG) and in three for rheumatoid arthritis. In three patients, KS developed under topical corticosteroid (TC) treatment. Among iatrogenic KS patients, ten of them had a second primary neoplasm and one had congenital immunodeficiency syndrome. Conclusions: Our study revealed one of the highest rates for iatrogenic KS (27%) reported in the literature. Besides well-known causes, relatively frequent association with MG was remarkable. Usage of different forms of TCs was the cause of KS in a few cases.
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Affiliation(s)
- Can Baykal
- Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Tugba Atci
- Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Nesimi Buyukbabani
- Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Armagan Kutlay
- Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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15
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Patel PU. An uncommon diagnosis for a recurrent erythematous patch in a paediatric patient. BMJ Case Rep 2017; 2017:bcr-2017-221935. [PMID: 29222219 DOI: 10.1136/bcr-2017-221935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 14-year-old girl presented with a circular erythematous patch over the left buttock for approximately 10 years, with ongoing ulceration and papules developing over the last 4 years. Punch biopsies were taken within and above the patch for diagnosis. Both revealed marked inflammatory infiltrates with atypical, irregular lymphocytes and increased mitosis. Immunostaining revealed CD8 positivity and a pan T helper cell phenotype. T cell receptor gene rearrangement analysis showed T cell clonality in both biopsies. These findings were consistent with mycosisfungoides and associated lymphomatoid papulosis. Both are rare conditions but have been associated in 5%-20% of cases. A definitive association has not yet been established; however, T cell monoclonality shows 50%-60% share a common origin. Management options are extensive with no one treatment showing superiority. Our patient received low-dose radiotherapy with good outcomes, but subsequently required further radiotherapy.
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Affiliation(s)
- Priya Umesh Patel
- Department of Dermatology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
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16
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Pileri A, Sgubbi P, Agostinelli C, Infusino SD, Vaccari S, Patrizi A. Photodynamic therapy: An option in mycosis fungoides. Photodiagnosis Photodyn Ther 2017; 20:107-110. [DOI: 10.1016/j.pdpdt.2017.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 08/25/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022]
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17
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Kelati A, Gallouj S, Tahiri L, Harmouche T, Mernissi FZ. Defining the mimics and clinico-histological diagnosis criteria for mycosis fungoides to minimize misdiagnosis. Int J Womens Dermatol 2017; 3:100-106. [PMID: 28560304 PMCID: PMC5440453 DOI: 10.1016/j.ijwd.2016.11.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 11/18/2016] [Accepted: 11/21/2016] [Indexed: 01/13/2023] Open
Abstract
Background Mycosis fungoides (MF) is a significant diagnostic challenge; it has various differential diagnosis especially at an early stage. Our aim was to describe mimics of MF clinically and histologically, and to define significant diagnostic criteria of the disease. Methods This was a retro-prospective cohort of 370 patients in whom the diagnosis of MF was suspected clinically. Results MF was histologically confirmed in 15.4% of cases and rejected in 84.5%. Other identified histologically diagnosis were eczema, psoriasis; nonspecific dermatitis, lichen, lupus; pseudolymphoma, parapsoriasis and toxidermia. 4 patients with palmoplantar MF were wrongly treated as eczema, and 10 patients with psoriasiform MF were initially treated as psoriasis. We also described the clinical, histological and immunohistochemistry diagnostic criteria for distinguishing MF from benign dermatosis. Conclusions Misdiagnosis of MF was a real problem for this study, because it shared common clinical and histological characteristics with other inflammatory diseases like eczema and psoriasis. Therefore, defining significant clinico-histological diagnosis criteria of MF would be of great help and would increase the accuracy of the diagnosis.
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Affiliation(s)
- A Kelati
- Department of Dermatology, Faculty of Medicine, Hospital Hassan II, Fez, Morocco
| | - S Gallouj
- Department of Dermatology, Faculty of Medicine, Hospital Hassan II, Fez, Morocco
| | - L Tahiri
- Department of Anatomopathology, Faculty of Medicine, Hospital Hassan II, Fez, Morocco
| | - T Harmouche
- Department of Anatomopathology, Faculty of Medicine, Hospital Hassan II, Fez, Morocco
| | - F Z Mernissi
- Department of Dermatology, Faculty of Medicine, Hospital Hassan II, Fez, Morocco
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18
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Saha M, Jain BB, Chattopadhyay S, Podder I. CD8-positive Mycosis Fungoides Masquerading as Pyoderma Gangrenosum. Indian J Dermatol 2016; 61:580. [PMID: 27688458 PMCID: PMC5029255 DOI: 10.4103/0019-5154.190126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mycosis fungoides (MF), a primary cutaneous T-cell lymphoma, accounts for <1% of non-Hodgkin lymphomas. The diagnosis of classic MF is based on a constellation of typical clinical presentation, histopathology, immunohistochemistry, and T-cell monoclonality detected by molecular studies. Rarely, atypical clinical presentation may occur. The typical immunohistochemical phenotype is, CD2 +ve, CD3 +ve, CD5 +ve, CD4 +ve, and CD8 − ve. Here, we report a rare case of CD8 +ve MF in a 43-year-male patient who was clinically diagnosed as pyoderma gangrenosum initially. The atypical presentation and rarity of such case have prompted this report.
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Affiliation(s)
- Maitrayee Saha
- Department of Pathology, Medical College, Kolkata, West Bengal, India
| | | | - Sarbani Chattopadhyay
- Department of Pathology, North Bengal Medical College, Darjeeling, West Bengal, India
| | - Indrashis Podder
- Department of Dermatology Venereology and Leprology, Medical College, Kolkata, West Bengal, India
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19
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McGirt LY, Degesys CA, Johnson VE, Zic JA, Zwerner JP, Eischen CM. TOX expression and role in CTCL. J Eur Acad Dermatol Venereol 2016; 30:1497-502. [PMID: 27345620 PMCID: PMC4992428 DOI: 10.1111/jdv.13651] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 02/09/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cutaneous T-cell lymphomas (CTCL) are skin malignancies including mycosis fungoides (MF) and CD30(+) lymphoproliferative disorders (LPD). In early disease, CTCL can be difficult to diagnose, especially in MF for which there is no reliable diagnostic marker. MF/CTCL have increased expression of thymocyte selection-associated HMG box protein (TOX). Although TOX has been proposed to be a diagnostic marker for MF, further validation studies are needed. Moreover, it is unclear what drives TOX expression or its role in MF/CTCL. OBJECTIVE We hypothesize evaluation of TOX levels across a spectrum of CTCL, including MF precursor (large plaque parapsoriasis, LPP), will help elucidate the implications of altered TOX expression. MATERIALS AND METHODS TOX staining was performed in MF, CD30(+) LPD, LPP as well as benign inflammatory dermatoses (BID) and normal skin (NS). CTCL cell lines were utilized to evaluate the regulation of TOX. RESULTS Positive TOX expression was identified in 73.6% of MF cases and in 31.6% of BID/NS. TOX had a positive predictive value (PPV) for MF of 86.7% and a negative predictive value (NPV) of 48.1%. TOX expression in MF was detected more commonly in Black patients (P = 0.015) and less commonly in transformed MF (P = 0.045). LPP had positive TOX staining in 70.0%. In CTCL cells, GATA3 knockdown decreased TOX mRNA and protein expression. TOX expression also decreased in the presence of CTCL therapeutics. CONCLUSION Our data indicate that TOX is useful as a diagnostic marker in MF. Moreover, TOX expression was evident in LPP, indicating it may have a previously unappreciated role in the development of MF. Finally, our data suggest that GATA3 regulates TOX, revealing insight into TOX regulation.
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Affiliation(s)
- L Y McGirt
- Department of Hematology/Oncology, Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC, USA
- Department of Medicine/Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - C A Degesys
- Department of Dermatology, Baylor College of Medicine, Houston, TX, USA
| | - V E Johnson
- Department of Medicine/Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - J A Zic
- Department of Medicine/Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - J P Zwerner
- Department of Medicine/Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - C M Eischen
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Cancer Biology and the Sidney Kimmel Comprehensive Cancer Center Thomas Jefferson University Philadelphia, PA, USA
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20
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LeBlanc RE, Lefterova MI, Suarez CJ, Tavallaee M, Kim YH, Schrijver I, Kim J, Gratzinger D. Lymph node involvement by mycosis fungoides and Sézary syndrome mimicking angioimmunoblastic T-cell lymphoma. Hum Pathol 2015; 46:1382-9. [PMID: 26193796 DOI: 10.1016/j.humpath.2015.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/28/2015] [Accepted: 05/29/2015] [Indexed: 10/23/2022]
Abstract
Clinical management of cutaneous T-cell lymphoma (CTCL) and angioimmunoblastic T-cell lymphoma (AITL) differs markedly. Diagnostic distinction is critical. Herein, we describe a series of 4 patients with clinically, molecularly, and histopathologically annotated mycosis fungoides or Sézary syndrome whose nodal disease mimicked AITL. The patients otherwise exhibited classic clinical manifestations of mycosis fungoides/Sézary syndrome preceding the onset of lymphadenopathy by 1 to 5 years. Skin biopsies revealed epidermotropic infiltrates characteristic of CTCL. Lymph node biopsies revealed dense CD4+ T-cell infiltrates that coexpressed follicular helper T-cell markers and were accompanied by proliferations of high endothelial venules and arborizing CD21+ follicular dendritic cell networks. Two patients had T-cell receptor gene rearrangement studies performed on their skin, lymph node, and peripheral blood demonstrating identical polymerase chain reaction clones in all 3 tissues. A small secondary clonal B-cell population was present in 1 patient that mimicked the B-cell proliferations known to accompany AITL and persisted on successive nodal biopsies over several years. This latter phenomenon has not previously been described in CTCL. The potential for patients to be misdiagnosed with AITL for lack of consideration of advanced-stage CTCL with nodal involvement underscores the necessity of information sharing among the various pathologists and clinicians involved in the care of each patient.
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Affiliation(s)
- Robert E LeBlanc
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305
| | - Martina I Lefterova
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305
| | - Carlos J Suarez
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305
| | - Mahkam Tavallaee
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305
| | - Youn H Kim
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305
| | - Iris Schrijver
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305
| | - Jinah Kim
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305
| | - Dita Gratzinger
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305.
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21
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Abstract
Mycosis fungoides (MF) represents almost 50% of all primary cutaneous lymphomas and more than 70% of cutaneous T-cell lymphomas (CTCL). Arising from preferentially skin-homing lymphocytes with genetic instability, MF evolves through stages (IA-IVB), producing inconspicuous inflammatory features in the beginning and finally resulting in a proliferation of cytomorphologic, phenotypic, and genotypic abnormal tumor cells. Over the past 200 years, there has been much confusion in the classification of lymphomas due to semantic disagreements (MF, CTCL, parapsoriasis, lymphosarcoma, reticulum cell sarcoma, and many other terms), lack of diagnostic standard criteria, and new molecular diagnostic methods. Studies on extracutaneous involvement in early stages (IA-IIA) are almost completely lacking. In advanced stages of MF (IIB-IVB), discovery of extracutaneous involvement is dependent on the methods used (physical examination, technology, molecular diagnostics, autopsy, and laparoscopy) and reveals a wide range of results. Due to the inflammation-simulating features in the beginning of the disease, early diagnosis is very difficult to assess. Extracutaneous involvement has previously been documented in more than 70% of autopsies. More recent studies give much lower figures. Like all lymphomas, MF is a systemic disease from the very beginning, with distinct homing preferences in tumor cells. Organs most commonly involved during the lengthy course of the disease are, in descending frequency, lymph node/peripheral blood, liver, spleen, lung, bone marrow, GI tract, pancreas, and kidney.
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Affiliation(s)
- Günter Burg
- Department of Dermatology, University of Zurich, Switzerland.
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22
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Sandlund JT, Perkins SL. Uncommon non-Hodgkin lymphomas of childhood: pathological diagnosis, clinical features and treatment approaches. Br J Haematol 2015; 169:631-46. [PMID: 25851546 DOI: 10.1111/bjh.13359] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We provide a review of the pathological and clinical features for uncommon B-cell and T-cell lymphomas of childhood with a specific focus on advances in treatment approaches and outcomes. There is clearly a need for prospective investigation of both the clinical and biological features of the uncommon non-Hodgkin lymphoma subtypes in childhood. These results should lead to more uniform and more effective treatment approaches.
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Affiliation(s)
- John T Sandlund
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Sherrie L Perkins
- Department of Pathology, University of Utah and ARUP Laboratories, Salt Lake City, UT, USA
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23
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Brazzelli V, Rivetti N, Badulli C, Carugno A, Cananzi R, De Silvestri A, Martinetti M, Borroni G. Mycosis fungoides: association of KIR ligands and HLA-DQB1*05 with bad prognosis of the disease. J Eur Acad Dermatol Venereol 2015; 30:266-9. [DOI: 10.1111/jdv.13083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 01/27/2015] [Indexed: 11/27/2022]
Affiliation(s)
- V. Brazzelli
- Department of Clinical-Surgical, Diagnostic and Pediatric Science; Institute of Dermatology; Pavia Italy
| | - N. Rivetti
- Department of Clinical-Surgical, Diagnostic and Pediatric Science; Institute of Dermatology; Pavia Italy
| | - C. Badulli
- Immunogenetic Laboratory; Immunohematology Service and Trasfusional Medicine; Pavia Italy
| | - A. Carugno
- Department of Clinical-Surgical, Diagnostic and Pediatric Science; Institute of Dermatology; Pavia Italy
| | - R. Cananzi
- Department of Clinical-Surgical, Diagnostic and Pediatric Science; Institute of Dermatology; Pavia Italy
| | - A. De Silvestri
- Biometry and Statistics; Fondazione IRCCS Policlinico San Matteo; University of Pavia; Pavia Italy
| | - M. Martinetti
- Immunogenetic Laboratory; Immunohematology Service and Trasfusional Medicine; Pavia Italy
| | - G. Borroni
- Department of Clinical-Surgical, Diagnostic and Pediatric Science; Institute of Dermatology; Pavia Italy
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24
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Pileri A, Agostinelli C, Righi S, Fuligni F, Bacci F, Sabattini E, Patrizi A, Pileri SA, Piccaluga PP. Vascular endothelial growth factor A (VEGFA) expression in mycosis fungoides. Histopathology 2014; 66:173-81. [PMID: 24766213 DOI: 10.1111/his.12445] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 04/23/2014] [Indexed: 11/30/2022]
Abstract
AIMS High levels of vascular endothelial growth factor A (VEGFA) seem to herald a worse prognosis in mycosis fungoides (MF). In this study, we aimed to characterize more clearly VEGFA gene and protein expression in MF. METHODS AND RESULTS First, we compared VEGFA mRNA levels in MF and in normal T lymphocyte samples; significantly higher VEGFA levels were found in MF. We then studied VEGFA expression in different normal T cell subsets, focusing on CD4(+) , CD8(+) , resting and activated T lymphocytes. We applied the gene signatures of the normal T cell subsets to MF samples and found that activated T lymphocytes represented the closest normal counterpart of the tumour. However, VEGFA mRNA levels were significantly higher in MF than in activated normal T cells, suggesting that VEGFA overexpression in MF represents an attribute acquired during neoplastic transformation: no significant VEGFA expression differences were recorded between early and advanced stages. Gene expression profile results were supported by immunohistochemistry in routine sections from 27 MF cases. CONCLUSIONS For the first time, we demonstrate VEGFA expression in MF cells, suggesting that the VEGF pathway may be implicated in MF pathogenesis and can represent a novel therapeutic target.
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Affiliation(s)
- Alessandro Pileri
- Dermatology Unit; Department Of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Italy
| | - Claudio Agostinelli
- Haematopathology Unit; Department Of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Italy
| | - Simona Righi
- Haematopathology Unit; Department Of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Italy
| | - Fabio Fuligni
- Haematopathology Unit; Department Of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Italy
| | - Francesco Bacci
- Haematopathology Unit; Department Of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Italy
| | - Elena Sabattini
- Haematopathology Unit; Department Of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Italy
| | - Annalisa Patrizi
- Dermatology Unit; Department Of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Italy
| | - Stefano A Pileri
- Haematopathology Unit; Department Of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Italy
| | - Pier Paolo Piccaluga
- Haematopathology Unit; Department Of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Italy
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25
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Savorani C, Manfé V, Biskup E, Gniadecki R. Ellipticine induces apoptosis in T-cell lymphoma via oxidative DNA damage. Leuk Lymphoma 2014; 56:739-47. [PMID: 24898668 DOI: 10.3109/10428194.2014.929673] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The tumor suppressor p53 is often mutated in human cancers. Restoring its antitumor activity has been shown to be a promising therapeutic approach for cancer treatment. Here we analyzed the activity and mechanism of a p53 reactivator, ellipticine, in a cellular model of cutaneous T-cell lymphoma (CTCL), a disease that is progressive, chemoresistant and refractory to treatment. We tested the effect of ellipticine in three cell lines with different p53 status: MyLa2000 (p53(wt/wt)), SeAx ((G245S)p53) and Hut-78 ((R196Stop)p53). Ellipticine caused apoptosis in MyLa2000 and SeAx and restored the transcriptional activity of (G245S)p53 in SeAx. However, p53 siRNA knockdown experiments revealed that p53 was not required for ellipticine-induced apoptosis in CTCL. The lipophilic antioxidant α-tocopherol inhibited ellipticine-dependent apoptosis and we linked the apoptotic response to the oxidative DNA damage. Our results provide evidence that ellipticine-induced apoptosis is exerted through DNA damage and does not require p53 activation in T-cell lymphoma.
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Affiliation(s)
- Cecilia Savorani
- Department of Dermatology, Bispebjerg Hospital , Copenhagen , Denmark
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26
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Cancers mimicking fungal infections. Adv Skin Wound Care 2014; 27:301-9. [PMID: 24932950 DOI: 10.1097/01.asw.0000446864.26807.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Primary and metastatic malignancies may occasionally mimic or coexist with cutaneous fungal infections. The authors report 3 cases of cancers that were initially presumed to be cutaneous fungal infections. Dermatologists should maintain a low threshold for skin biopsy in patients with persistent or refractory fungal infections.
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27
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McGirt LY, Baerenwald DA, Vonderheid EC, Eischen CM. Early changes in miRNA expression are predictive of response to extracorporeal photopheresis in cutaneous T-cell lymphoma. J Eur Acad Dermatol Venereol 2014; 29:2269-71. [PMID: 24909834 DOI: 10.1111/jdv.12571] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- L Y McGirt
- Department of Hematology/Oncology, Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC, USA.,Department of Dermatology/Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - D A Baerenwald
- Department of Dermatology/Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - E C Vonderheid
- Department of Oncology, Johns Hopkins Medical Institution, Baltimore, MD, USA
| | - C M Eischen
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
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28
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Aydogan K, Yazici S, Balaban Adim S, Tilki Gunay I, Budak F, Saricaoglu H, Tunali S, Bulbul Baskan E. Efficacy of low-dose ultraviolet a-1 phototherapy for parapsoriasis/early-stage mycosis fungoides. Photochem Photobiol 2014; 90:873-7. [PMID: 24502428 DOI: 10.1111/php.12253] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 01/29/2014] [Indexed: 01/19/2023]
Abstract
Mycosis fungoides (MF) and parapsoriasis (PP) are major dermatologic conditions for which phototherapy continues to be a successful and valuable treatment option. UVA-1 phototherapy is effective in the management of cutaneous T-cell mediated diseases. The aim of the study was to evaluate the efficacy and safety of low-dose UVA-1 phototherapy for the management of PP/early-stage MF. A total of 30 patients, diagnosed with MF (n:19) or PP (n:11) were enrolled to the study. All patients were managed with low-dose UVA-1 (20 or 30 J cm(-2)). Response was assessed clinically and immunohistochemically. UVA-1 treatment led to clinical and histological complete remission (CR) in 11 of 19 MF patients (57.9%), partial remission (PR) in three of 19 (15.8%), after a mean cumulative dose of 1665 (range, 860-3120) J cm(-2) and mean number of 73 exposure (range, 43-107) sessions. Five patients with PP (45.5%) showed CR, and PR was observed in six patients with PP (54.5%) after a mean cumulative dose of 1723 (range, 1060-3030) J cm(-2) and mean number of 74 exposure (range, 53-101) sessions. We conclude that low-dose UVA-1 therapy seems to be an effective, safe, and well-tolerated treatment option for patients with PP/early-stage MF.
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Affiliation(s)
- Kenan Aydogan
- Department of Dermatology and Venereology, Uludag University School of Medicine, Bursa, Turkey
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29
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Brazzelli V, Rivetti N, Badulli C, Carugno A, Grasso V, De Silvestri A, Martinetti M, Borroni G. Immunogenetic factors in mycosis fungoides: can the HLA system influence the susceptibility and prognosis of the disease? Long-term follow-up study of 46 patients. J Eur Acad Dermatol Venereol 2014; 28:1732-7. [DOI: 10.1111/jdv.12391] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 01/10/2014] [Indexed: 12/20/2022]
Affiliation(s)
- V. Brazzelli
- Department of Clinical-Surgical; Diagnostic and Pediatric Science; Institute of Dermatology; Pavia Italy
| | - N. Rivetti
- Department of Clinical-Surgical; Diagnostic and Pediatric Science; Institute of Dermatology; Pavia Italy
| | - C. Badulli
- Immunohematology Service and Trasfusional Medicine; Immunogenetic Laboratory; Pavia Italy
| | - A. Carugno
- Department of Clinical-Surgical; Diagnostic and Pediatric Science; Institute of Dermatology; Pavia Italy
| | - V. Grasso
- Department of Clinical-Surgical; Diagnostic and Pediatric Science; Institute of Dermatology; Pavia Italy
| | - A. De Silvestri
- Biometry and Statistics; Fondazione IRCCS Policlinico San Matteo; University of Pavia; Pavia Italy
| | - M. Martinetti
- Immunohematology Service and Trasfusional Medicine; Immunogenetic Laboratory; Pavia Italy
| | - G. Borroni
- Department of Clinical-Surgical; Diagnostic and Pediatric Science; Institute of Dermatology; Pavia Italy
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30
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Marçal N, Campelos S, Dias L, Gonçalves M, Pereira G, Godinho T. Primary cutaneous CD30-positive anaplastic large-cell lymphoma of the external auditory canal. EAR, NOSE & THROAT JOURNAL 2013; 91:E10-2. [PMID: 23288823 DOI: 10.1177/014556131209101214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Primary cutaneous T-cell lymphoma is rare. Cutaneous lymphoma is defined as primary when there is an absence of nodal or systemic disease during the first 6 months following diagnosis. We report what we believe to be the first documented case of a primary cutaneous CD30-positive anaplastic large-cell lymphoma of the external auditory canal. The patient was an elderly woman who presented with progressively worsening right otalgia and hypoacusis. Otoscopy revealed an erythematic, ulcerative, nonbleeding, localized lesion in the anterosuperior area of the external auditory canal. The patient underwent an excisional biopsy, and after the diagnosis was established, she underwent 22 sessions of radiotherapy. During follow-up, she exhibited no evidence of recurrence.
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Affiliation(s)
- Nuno Marçal
- Department of Otorhinolaryngology, Hospital de São Marcos, Sete Fontes, Braga, Portugal.
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Jang MS, Jang JG, Han SH, Park JB, Kang DY, Kim ST, Suh KS. Clinicopathological features of mycosis fungoides in patients exposed to Agent Orange during the Vietnam War. J Dermatol 2013; 40:606-12. [DOI: 10.1111/1346-8138.12202] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 04/22/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Min Soo Jang
- Department of Dermatology; Kosin University College of Medicine; Busan; South Korea
| | - Jun Gyu Jang
- Department of Dermatology; Kosin University College of Medicine; Busan; South Korea
| | - Sang Hwa Han
- Department of Dermatology; Kosin University College of Medicine; Busan; South Korea
| | - Jong Bin Park
- Department of Dermatology; Kosin University College of Medicine; Busan; South Korea
| | - Dong Young Kang
- Department of Dermatology; Kosin University College of Medicine; Busan; South Korea
| | - Sang Tae Kim
- Department of Dermatology; Kosin University College of Medicine; Busan; South Korea
| | - Kee Suck Suh
- Department of Dermatology; Kosin University College of Medicine; Busan; South Korea
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32
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Sézary syndrome: A study of 176 patients at Mayo Clinic. J Am Acad Dermatol 2012; 67:1189-99. [DOI: 10.1016/j.jaad.2012.04.043] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 04/26/2012] [Accepted: 04/28/2012] [Indexed: 01/20/2023]
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Morell L, Bassas-Vila J, Mate J, Bielsa I. Cutaneous B-cell Lymphoma: The Importance of Clinicopathologic Correlation. ACTAS DERMO-SIFILIOGRAFICAS 2012. [DOI: 10.1016/j.adengl.2012.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Kim M, Thompson LA, Wenger SD, O'Bryant CL. Romidepsin: A Histone Deacetylase Inhibitor for Refractory Cutaneous T-Cell Lymphoma. Ann Pharmacother 2012; 46:1340-8. [DOI: 10.1345/aph.1r036] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Objective: To evaluate the efficacy and safety of romidepsin in refractory cutaneous T-cell lymphoma (CTCL). Data Sources: An English-language literature search of PubMed and MEDLINE (Nov 2011–April 2012) was performed using the terms romidepsin, CTCL, and depsipeptide (FK228). The National Comprehensive Cancer Network guidelines, American Society of Clinical Oncology abstracts, American Society of Hematology abstracts, clinical trial registry, and prescribing information from the manufacturer were reviewed for additional information. Study Selection and Data Extraction: Phase 1 and 2 trials evaluating the efficacy and safety of romidepsin were reviewed with a specific focus on its use in cutaneous T-cell lymphoma. All peer-reviewed articles with clinically relevant information were evaluated for inclusion. Data Synthesis: In advanced stage CTCL, single or combination chemotherapy regimen responses are variable and lack durability. Romidepsin is a histone deacetylase inhibitor approved for refractory cutaneous T-cell lymphoma, Romidepsin has shown an improvement in duration of response and pruritus over traditional therapy. In 2 independent Phase 2 trials, romidepsin showed an overall response rate of 34% and durable response of 13–15 months in patients with refractory CTCL. The most frequent toxicities of romidepsin include nausea. vomiting, fatigue, or myelosuppresston. Clinically insignificant QT interval changes have been observed but did not correlate with a decrease in left ventricular ejection fraction, or elevated laboratory markers of myocardial damage. Conclusions: Romidepsin is an effective, durable, and well-tolerated single-agent therapy in patients with refractory CTCL and should be considered for formulary addition in this population.
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Affiliation(s)
- Miryoung Kim
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora
| | - Lisa A Thompson
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado
| | - Sarah D Wenger
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado
| | - Cindy L O'Bryant
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado
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35
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Not all that itches is urticaria. Ann Allergy Asthma Immunol 2012; 109:10-3. [PMID: 22727151 DOI: 10.1016/j.anai.2012.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 05/10/2012] [Accepted: 05/11/2012] [Indexed: 11/23/2022]
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36
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Morell L, Bassas-Vila J, Mate JL, Bielsa I. Cutaneous B-cell lymphoma: the importance of clinicopathologic correlation. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:746-8. [PMID: 22579036 DOI: 10.1016/j.ad.2011.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Revised: 10/18/2011] [Accepted: 11/13/2011] [Indexed: 11/17/2022] Open
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37
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Gene therapy in interventional pulmonology: Interferon gene delivery with focus on thoracic malignancies. ACTA ACUST UNITED AC 2012. [DOI: 10.1007/s13665-011-0008-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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38
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Brooks C, Pulitzer MP, Brownell I. Longitudinal lift biopsy technique with flat fixation for the diagnosis of mycosis fungoides. Int J Dermatol 2011; 50:875-6. [PMID: 21699527 DOI: 10.1111/j.1365-4632.2010.04806.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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McGirt LY, Thoburn C, Hess A, Vonderheid EC. Predictors of response to extracorporeal photopheresis in advanced mycosis fungoides and Sézary syndrome. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2010; 26:182-91. [PMID: 20626820 DOI: 10.1111/j.1600-0781.2010.00514.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Extracorporeal photopheresis (ECP) has been utilized for more than 20 years to treat cutaneous T-cell lymphoma (CTCL), but a clinical response can take up to 9 months to manifest. This study was undertaken to determine whether clinical features, laboratory values, cytokine levels, or gene expression levels of tumor markers are useful to predict the subsequent response to ECP in CTCL patients with blood involvement. METHODS Twenty-one patients with CTCL treated with ECP as monotherapy for at least 6 months were retrospectively identified. Laboratory and clinical data and blood obtained at baseline, 3, and 6 months of treatment were used for analysis. RESULTS In pretreatment blood specimens, a lower percentage of Sézary cells and a higher absolute eosinophil count were associated with a favorable clinical response. Clinical evidence of an early response after 3 months of ECP did not reliably predict a favorable response at 6 months or beyond. Comparison of cytokines, gene transcripts, and other laboratory measures of disease did not correlate with the subsequent clinical response, although lactate dehydrogenase levels tended to decrease progressively in ECP-responsive cases and increase progressively in ECP-non-responsive cases. Additionally, serum levels of TNF-alpha significantly increased from baseline to 6 months of ECP, but was not found to correlate with the clinical response. CONCLUSIONS Although we found that increased eosinophils and decreased percentage of Sézary cells were associated with a favorable clinical response to ECP, we were not able to identify the predictors of ECP response within the first 3 months of treatment.
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Affiliation(s)
- Laura Y McGirt
- Dermatology, Johns Hopkins Medical Institutes, Baltimore, MD, USA.
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40
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Abstract
Recent medical advances have improved the understanding, diagnosis, and treatment of paraneoplastic syndromes. These disorders arise from tumor secretion of hormones, peptides, or cytokines or from immune cross-reactivity between malignant and normal tissues. Paraneoplastic syndromes may affect diverse organ systems, most notably the endocrine, neurologic, dermatologic, rheumatologic, and hematologic systems. The most commonly associated malignancies include small cell lung cancer, breast cancer, gynecologic tumors, and hematologic malignancies. In some instances, the timely diagnosis of these conditions may lead to detection of an otherwise clinically occult tumor at an early and highly treatable stage. Because paraneoplastic syndromes often cause considerable morbidity, effective treatment can improve patient quality of life, enhance the delivery of cancer therapy, and prolong survival. Treatments include addressing the underlying malignancy, immunosuppression (for neurologic, dermatologic, and rheumatologic paraneoplastic syndromes), and correction of electrolyte and hormonal derangements (for endocrine paraneoplastic syndromes). This review focuses on the diagnosis and treatment of paraneoplastic syndromes, with emphasis on those most frequently encountered clinically. Initial literature searches for this review were conducted using PubMed and the keyword paraneoplastic in conjunction with keywords such as malignancy, SIADH, and limbic encephalitis, depending on the particular topic. Date limitations typically were not used, but preference was given to recent articles when possible.
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Affiliation(s)
| | - David E. Gerber
- Individual reprints of this article are not available. Address correspondence to David. E. Gerber, MD, Division of Hematology-Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code 8852, Dallas, TX 75390-8852 ()
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SALEHI M, AZIMI Z, FATEMI F, RAJABI P, KAZEMI M, AMINI G. Incidence rate of mycosis fungoides in Isfahan (Iran). J Dermatol 2010; 37:703-7. [DOI: 10.1111/j.1346-8138.2010.00899.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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42
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Nassem S, Kashyap R, Awasthi NP, Krishnani N, Kumari N. Sézary syndrome presenting with âleonine faciesâ. Australas J Dermatol 2009; 50:285-8. [DOI: 10.1111/j.1440-0960.2009.00560.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Doukaki S, Aricò M, Bongiorno MR. A Rare Presentation of Mycosis Fungoides Mimicking Psoriasis Vulgaris. Case Rep Dermatol 2009; 1:60-65. [PMID: 20652117 PMCID: PMC2895213 DOI: 10.1159/000249148] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Mycosis fungoides (MF) is an uncommon primary cutaneous lymphoma with a wide spectrum of clinicopathological manifestations. Diagnosis can be difficult in its early stages given the considerable overlap with more common benign dermatoses. We report an unusual case of MF in a 52-year-old male presenting with psoriasiform plaques on the palms and the soles who rapidly developed additional lesions on the scalp, limps and trunk. Punch biopsy of the face was obtained for routine histology and immunohistochemical stains. Chest X-ray, total body computed tomography scanning and excisional biopsy of the inguinal lymph node were performed. Review of the face biopsy revealed a diffuse dermal infiltrate containing a high number of atypical lymphocytes showing a CD3+, CD4+, CD45RO+, CD8-, CD20- immunophenotype and epidermotropism. Findings were consistent with tumor stage MF (stage IIB, T3 N1 M0). We report a rare presentation of MF mimicking psoriasis vulgaris.
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Affiliation(s)
- S Doukaki
- Department of Dermatology, University of Palermo, Palermo, Italy
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44
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Moore PF, Affolter VK, Graham PS, Hirt B. Canine epitheliotropic cutaneous T-cell lymphoma: an investigation of T-cell receptor immunophenotype, lesion topography and molecular clonality. Vet Dermatol 2009; 20:569-76. [DOI: 10.1111/j.1365-3164.2009.00814.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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45
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Amitay-Laish I, David M, Hodak E. Systemic progression following complete cutaneous remission under bexarotene treatment for tumor-stage mycosis fungoides. J Am Acad Dermatol 2009; 61:361-2. [PMID: 19615550 DOI: 10.1016/j.jaad.2009.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2009] [Revised: 02/08/2009] [Accepted: 02/09/2009] [Indexed: 12/01/2022]
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46
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Hoeller C, Richardson SK, Ng LG, Valero T, Wysocka M, Rook AH, Weninger W. In vivo Imaging of Cutaneous T-Cell Lymphoma Migration to the Skin. Cancer Res 2009; 69:2704-8. [DOI: 10.1158/0008-5472.can-08-2891] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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47
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Abstract
This case report details an 85-year-old woman who presented with mycosis fungoides (MF), clinical stage 1A. Bilateral lesions on the upper thighs were responsive to topical steroid therapy. Biopsies showed band-like dermal infiltrates of medium-sized lymphocytes with marked epidermotropism, including large intraepidermal lymphocytes with nuclear convolutions, consistent with MF. Immunohistochemical staining revealed that the lesional cells were CD56+, but unlike the case in previous reports of CD56+ MF, they also expressed CD4 and T-cell intracellular antigen 1 and did not express CD8. To our knowledge, this is the first description of a case of MF with a CD4+, CD8-, CD56+, T-cell intracellular antigen 1-positive immunophenotype. At 85 years of age, the patient is older than all previously described patients with CD56+ MF. Despite an immunophenotype observed more commonly in aggressive forms of cutaneous T-cell lymphoma, the clinical presentation is that of typical MF. The patient presented with limited disease and after 12 months of follow-up has not progressed beyond stage 1A.
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48
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Wechsler J. [Diagnostic problems posed by cutaneous lymphocytic infiltrates]. Ann Dermatol Venereol 2009; 136:160-7. [PMID: 19232253 DOI: 10.1016/j.annder.2008.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J Wechsler
- Département de pathologie, CHU Henri-Mondor, 51, avenue de Lattre-de-Tassigny, 94010 Créteil, France.
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Lee TK, Baron ED, Foster TH. Monitoring Pc 4 photodynamic therapy in clinical trials of cutaneous T-cell lymphoma using noninvasive spectroscopy. JOURNAL OF BIOMEDICAL OPTICS 2008; 13:030507. [PMID: 18601524 PMCID: PMC2527126 DOI: 10.1117/1.2939068] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Silicon phthalocyanine Pc 4 photodynamic therapy (Pc 4-PDT) has emerged as a potentially effective treatment for cutaneous T-cell lymphoma (CTCL). Noninvasive reflectance and fluorescence spectroscopy before, during, and after PDT may provide useful dose metrics and enable therapy to be tailored to individual lesions. We present the design and implementation of a portable bedside spectroscopy system for initial clinical trials of Pc 4-PDT of CTCL. Reflectance and fluorescence spectra were obtained from an early stage CTCL patient throughout the course of the PDT treatment. Preliminary patient data show a significant effect of Pc 4 on the tissue absorption, modest Pc 4 photobleaching, and heterogeneity of Pc 4 within and between the lesions.
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Affiliation(s)
- Tammy K. Lee
- University of Rochester, Institute of Optics and Department of Imaging Sciences, Rochester, New York 14642
| | - Elma D. Baron
- Case Western Reserve University, University Hospitals of Cleveland, Department of Dermatology, Cleveland, Ohio 44106
| | - Thomas H. Foster
- University of Rochester, Institute of Optics and Department of Imaging Sciences, Rochester, New York 14642
- Tel: 585–275–1347; E-mail:
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