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Haber R, Feghali J, Nadir U, Yi MD, Cahn BA. Acquired ichthyosis: a clinical review. Arch Dermatol Res 2023; 315:2529-2543. [PMID: 37422878 DOI: 10.1007/s00403-023-02668-5] [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: 06/06/2023] [Revised: 06/06/2023] [Accepted: 06/28/2023] [Indexed: 07/11/2023]
Abstract
Acquired ichthyosis (AI) is a rare, nonhereditary cutaneous disorder that has been associated with numerous neoplastic, infectious, drugs, endocrine, metabolic, autoimmune, and malabsorptive diseases. Review all demographical, clinical, histological, and therapeutic features of AI and focus on all reported associated diseases. We performed a systematic literature review in Pubmed/Medline, Embase, and Cochrane collaboration databases, searching for all articles on AI, with no limits on publication date, participant age, sex or nationality. Eighty-four articles were included. Total number of included patients was 167 patients with a mean age at presentation of 39 years [range 0.5-85] and a sex ratio M:F of 5:2. The most common malignancy associated with AI is Hodgkin's lymphoma. AI occurred before, simultaneously or after the onset of malignancy or systemic disease. The severity of AI depends on the severity of the underlying disorder and regresses once the disease goes into remission and may also be a marker of disease recurrence or relapse. 8% have been reported to be drug related and all occurred weeks to months after drug intake and resolved after stopping or decreasing the dose of the drug. Data were derived from case reports and observational studies. Limitations include the accuracy of published data, potential patient selection, and reporting bias. AI can be associated with numerous systemic diseases and drugs. Physicians should be particularly alert to these associations to provide adequate screening and management of patients with AI.
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Affiliation(s)
- Roger Haber
- Department of Dermatology, University of Illinois-Chicago, 808 South Wood Street (MC 624), Suite 380 College of Medicine East Tower, Chicago, IL, 60612, USA
| | - Joelle Feghali
- Department of Dermatology, Saint George Hospital University Medical Center, Beirut, Lebanon
- Faculty of Medicine, Balamand University, El-Koura, Lebanon
| | - Umer Nadir
- Department of Dermatology, Feinberg School of Medicine, Chicago, IL, USA
| | - Michael D Yi
- Department of Dermatology, Feinberg School of Medicine, Chicago, IL, USA
| | - Brian A Cahn
- Department of Dermatology, University of Illinois-Chicago, 808 South Wood Street (MC 624), Suite 380 College of Medicine East Tower, Chicago, IL, 60612, USA.
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Lebas E, Collins P, Somja J, Nikkels AF. A Comprehensive Update of the Atypical, Rare and Mimicking Presentations of Mycosis Fungoides. Dermatol Ther (Heidelb) 2021; 11:1931-1951. [PMID: 34709600 PMCID: PMC8611162 DOI: 10.1007/s13555-021-00625-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction Mycosis fungoides (MF) is the most frequent subtype of primary cutaneous T cell lymphomas (pCTCL). The diagnosis may be particularly difficult in the early stages as well as in atypical and rare clinical presentations. Furthermore, MF may simulate a large variety of common dermatologic disorders and patterns, both histopathologically and clinically. Methods A literature search was performed to provide a comprehensive update on the rare and atypical MF manifestations as well as the dermatoses and dermatological patterns that could be imitated by MF. Results A total of 114 publications were found describing a series of different dermatoses and dermatological patterns mimicked by MF, as well as some particular localizations of MF lesions and dermatoses that occur in preexisting MF lesions. Conclusions The number of dermatoses that can be imitated by MF is ever-increasing. Patients with common dermatologic conditions that prove to be treatment refractory should be biopsied without delay, and sequentially as necessary, to prevent delay in diagnosis and progression of disease. Clinicopathologic correlation is the best way of diagnosis.
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Affiliation(s)
- Eve Lebas
- Department of Dermatology, CHU du Sart Tilman, University of Liège, 4000, Liège, Belgium
| | - Patrick Collins
- Department of Dermatopathology, CHU du Sart Tilman, University of Liège, 4000, Liège, Belgium
| | - Joan Somja
- Department of Dermatopathology, CHU du Sart Tilman, University of Liège, 4000, Liège, Belgium
| | - Arjen F Nikkels
- Department of Dermatology, CHU du Sart Tilman, University of Liège, 4000, Liège, Belgium.
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Alsayyah A. Is it mycosis fungoides? A comprehensive guide to reaching the diagnosis and avoiding common pitfalls. Ann Diagn Pathol 2020; 47:151546. [PMID: 32554312 DOI: 10.1016/j.anndiagpath.2020.151546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/07/2020] [Accepted: 05/19/2020] [Indexed: 12/14/2022]
Abstract
Mycosis Fungoides (MF) is known as 'the great mimicker' due to its capacity to emulate several dermatoses, both in the clinic and on histology. This often leads to the diagnosis being missed or delayed, which consequently leads to poorer prognosis. For a timely diagnosis, it is crucial that the physician is aware of the various clinical and histological presentations of MF, as well as the proper diagnostic protocols. In the current review, we concisely encapsulate all the variants of MF as well has the conditions it mimics clinically and histologically. Through this, we aim to provide clinicians with a holistic picture of MF and help them determine when to suspect this disease and steps to take in order to nail the diagnosis.
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Affiliation(s)
- Ahmed Alsayyah
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Post Box No. 1982, Dammam 31441, Saudi Arabia.
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4
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Wang R, Wang Y, Lin Z. Dry Scaly Patches and Nodules in a Middle-aged Man. JAMA Dermatol 2019; 155:1185-1186. [PMID: 31411644 DOI: 10.1001/jamadermatol.2019.1987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Ruojun Wang
- Department of Dermatology, Peking University First Hospital, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Yang Wang
- Department of Dermatology, Peking University First Hospital, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Zhimiao Lin
- Department of Dermatology, Peking University First Hospital, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
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Perandones González H, Sánchez Sambucety P, Rodríguez Prieto MÁ. Ichthyosiform pattern: an exceptional presentation of mycosis fungoides. Int J Dermatol 2019; 59:730-732. [PMID: 31498889 DOI: 10.1111/ijd.14636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/27/2019] [Accepted: 08/08/2019] [Indexed: 11/28/2022]
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7
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Tanita K, Fujimura T, Sato Y, Hidaka T, Furudate S, Kambayashi Y, Tsukada A, Hashimoto A, Aiba S. Successful Treatment of Primary Cutaneous Peripheral T-Cell Lymphoma Presenting Acquired Ichthyosis with Oral Bexarotene Monotherapy. Case Rep Oncol 2017; 10:328-332. [PMID: 28512419 PMCID: PMC5422724 DOI: 10.1159/000468981] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 03/07/2017] [Indexed: 11/22/2022] Open
Abstract
Acquired ichthyosis (AI) is a reactive cutaneous manifestation that can be associated with malignant hematological disease, including cutaneous T-cell lymphoma (CTCL). Since it is difficult to distinguish AI from ichthyosiform mycosis fungoides, to select the treatment for CTCL with ichthyosis-like appearance and to evaluate its efficacy is sometimes challenging. In this report, we describe a case of primary cutaneous peripheral T-cell lymphoma not otherwise specified presenting AI successfully treated with oral bexarotene. In the present case, the administration of oral bexarotene was not only effective for lymphoma cells infiltrating ulcers and nodules, but it also eliminated AI.
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Affiliation(s)
- Kayo Tanita
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yota Sato
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takanori Hidaka
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sadanori Furudate
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yumi Kambayashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Tsukada
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Wobser M, Geissinger E, Rosenwald A, Goebeler M. Mycosis fungoides: A mimicker of benign dermatoses. World J Dermatol 2015; 4:135-144. [DOI: 10.5314/wjd.v4.i4.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 08/21/2014] [Accepted: 07/17/2015] [Indexed: 02/06/2023] Open
Abstract
Mycosis fungoides, the most common primary cutaneous lymphoma, may present with a broad spectrum of clinical features. As both clinical and dermatopathological findings in mycosis fungoides occasionally closely imitate other dermatoses, correct diagnosis may be a challenge both for clinicians as well as dermatopathologists. As a consequence, diagnosis of cutaneous lymphoma may be initially missed and, therefore, prompt and adequate therapeutic measures delayed. Hence, the purpose of our article was to give an overview of hitherto published “mimickers” of mycosis fungoides with a review of its diverse clinical features to alert the clinicians about the wide spectrum of this dissimulating disease. By integrating our own encountered atypical cases of mycosis fungoides we provide a comprehensive illustrated histological and moleculargenetic workup thereof and thereby critically revise the different available diagnostic tools of daily routine. Finally, we derive a practical algorithm to obtain the correct diagnosis even in such ambiguous cases of mycosis fungoides.
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Cho-Vega JH, Tschen JA, Duvic M, Vega F. Early-stage mycosis fungoides variants: case-based review. Ann Diagn Pathol 2011; 14:369-85. [PMID: 20850703 DOI: 10.1016/j.anndiagpath.2010.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2010] [Accepted: 06/22/2010] [Indexed: 02/04/2023]
Abstract
Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma. The diagnosis of classic MF is based on a combination of clinical presentation, histopathology, and T-cell monoclonality detected by molecular studies. However, the diagnosis can be difficult in cases of early MF because of the subtle nature of histologic findings and, in cases of variants of MF, because of the unusual clinical and/or pathologic features. In this review, we presented the most frequent variants of MF at early stage including hypopigmented, folliculotropic, pagetoid reticulosis, unilesional, granulomatous, and ichthyosis forms. This case-based clinicopathologic review provides the notion that a comprehensive clinicopathologic correlation is of substantial importance to render the diagnosis of MF. In addition, we discuss the role of molecular studies, which are highly sensitive and recently more applicable to routinely processed skin biopsy specimens in the diagnosis of MF.
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Hali F, Latifi A, Sbai M. [A dermatosis that reveals another…]. Presse Med 2011; 40:455-7. [PMID: 21255966 DOI: 10.1016/j.lpm.2010.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 11/03/2010] [Accepted: 11/04/2010] [Indexed: 10/18/2022] Open
Affiliation(s)
- Fouzia Hali
- CH Ibn Rochd, service de dermatologie vénéréologie, Casablanca, Maroc.
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Nam KH, Park J, Hong JS, Roh SG, Kim DS, Yun SK. Mycosis fungoides as an ichthyosiform eruption. Ann Dermatol 2010; 21:182-4. [PMID: 20523782 DOI: 10.5021/ad.2009.21.2.182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Accepted: 10/09/2008] [Indexed: 11/08/2022] Open
Abstract
Ichthyosiform eruption as a specific manifestation of mycosis fungoides is very rare and only a few such cases have currently been reported in the medical literature. A 63-year-old Korean man presented with a 4-year history of a pruritic ichthyotic eruption. There was no personal or family history of ichthyosis or atopy. The ichthyosiform skin changes involved the abdomen, arms, thighs and shins. The face, palms and soles were spared. There was no peripheral lymphadenopathy or organomegaly. The typical lesions of mycosis fungoides were not present. The results of the routine investigations were normal or negative. A skin biopsy specimen revealed the findings of early mycosis fungoides. He was successfully treated with photochemotherapy.
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Affiliation(s)
- Kyung-Hwa Nam
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea
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Kim ST, Sim HJ, Jeon YS, Lee JW, Roh HJ, Choi SY, Kim YJ, Suh KS. Clinicopathological features and T-cell receptor gene rearrangement findings of mycosis fungoides in patients younger than age 20 years. J Dermatol 2009; 36:392-402. [PMID: 19583687 DOI: 10.1111/j.1346-8138.2009.00665.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma that usually arises in middle-aged or older people. The incidence of childhood MF is low, but studies in childhood MF suggests that the incidence is rising. The number of studies in childhood MF are few and there are currently no studies about childhood MF in Asians. We investigated the clinicopathological features, T-cell receptor (TCR) gene rearrangement findings, treatment and follow up in childhood MF. The retrospective study was performed on a population consisting of 23 MF patients aged 4-19 years. The duration of the disease ranged from 1 month to 10 years (mean, 2.7 years). In Tumor-Node-Metastasis classifications, all cases were confined to stage IA or IB. Histopathological findings revealed epidermotropism and perivascular infiltrates, epidermotropism in the infundibulum, Pautrier's microabscess, haloed lymphocytes, epidermal lymphocytes larger than dermal lymphocytes, atypical cells with hyperchromatic nuclei and wiry bundles of collagen. TCRgamma gene rearrangement was performed except for four patients, and monoclonality was detected in 16 of 19 cases (84%). Treatment was done with psoralen and ultraviolet (UV)A, UVA1, narrow-band UVB, topical steroid, retinoic acid and calcipotriol. Most patients showed a good response. At a mean follow up of 90.4 months, no patient had either an exacerbation of the disease or extracutaneous involvement. Compared with adult-onset MF, MF in children may show a variety of clinical features. It is considered to have a good prognosis. Moreover, histopathological study and TCR gene rearrangement study can help in the diagnosis of MF in children.
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Affiliation(s)
- Sang-Tae Kim
- Department of Dermatology, Kosin University College of Medicine, Busan 602-702, Korea
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13
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Martorell-Calatayud A, Botella-Estrada R, Sanmartín-Jimenez O, Requena C, Guillén-Barona C, Sangüeza OP. Papular mycosis fungoides: two new cases of a recently described clinicopathological variant of early mycosis fungoides. J Cutan Pathol 2009; 37:330-5. [PMID: 19737334 DOI: 10.1111/j.1600-0560.2009.01417.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma. In early stages of the disease many different clinicopathologic variants have been observed. Currently, a papular variant of MF which is characterized by a good prognosis has been described. OBJECTIVE AND METHODS Because only seven cases have been reported in the literature, clinical and morphological data of this variant are not well established. We report the clinical and histopathological characteristics of two new patients with papular mycosis fungoides and review the previous cases reported in the literature. RESULTS The two cases of this early variant of MF were characterized by the presence of papules which, unlike the papules of lymphomatoid papulosis, did not show a tendency for spontaneous resolution. Histologic examination confirmed the diagnosis of MF in all cases. Immunohistochemical staining for CD30 was negative in all two cases. Follow-up data of our two patients confirmed the non-aggressive behavior of the disease, confirming that the lesions were not manifestations of advanced MF. CONCLUSION Papular MF is a new variant of early MF characterized by a good prognosis in the long term follow- up. Thus, it should be added to the long list of clinicopathologic subtypes of MF.
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Ryan C, Whittaker S, D’Arcy C, O’Regan GM, Rogers S. Juvenile folliculotropic and ichthyosiform mycosis fungoides. Clin Exp Dermatol 2009; 34:e160-2. [DOI: 10.1111/j.1365-2230.2008.03051.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Morizane S, Setsu N, Yamamoto T, Hamada T, Nakanishi G, Asagoe K, Iwatsuki K. Ichthyosiform eruptions in association with primary cutaneous T-cell lymphomas. Br J Dermatol 2009; 161:115-20. [DOI: 10.1111/j.1365-2133.2009.09109.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Mycosis fungoides (MF), a low-grade lymphoproliferative disorder, is the most common type of cutaneous T-cell lymphoma. Typically, neoplastic T cells localize to the skin and produce patches, plaques, tumours or erythroderma. Diagnosis of MF can be difficult due to highly variable presentations and the sometimes nonspecific nature of histological findings. Molecular biology has improved the diagnostic accuracy. Nevertheless, clinical experience is of substantial importance as MF can resemble a wide variety of skin diseases. We performed a literature review and found that MF can mimic >50 different clinical entities. We present a structured framework of clinical variations of classical, unusual and distinct forms of MF. Distinct subforms such as ichthyotic MF, adnexotropic (including syringotropic and folliculotropic) MF, MF with follicular mucinosis, granulomatous MF with granulomatous slack skin and papuloerythroderma of Ofuji are delineated in more detail.
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Affiliation(s)
- D Nashan
- Department of Dermatology, University of Freiburg, Hautstrasse 7, 79104 Freiburg, Germany.
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Patel N, Spencer LA, English JC, Zirwas MJ. Acquired ichthyosis. J Am Acad Dermatol 2006; 55:647-56. [PMID: 17010746 DOI: 10.1016/j.jaad.2006.04.047] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2005] [Revised: 04/07/2006] [Accepted: 04/10/2006] [Indexed: 11/17/2022]
Abstract
Acquired ichthyosis (AI) is a nonhereditary cutaneous disorder characterized by dry, rough skin with prominent scaling that involves significant portions of the body. It has been associated with malignancies; autoimmune/inflammatory, metabolic, endocrine, and infectious diseases; and medication use. Most microscopic studies of AI exhibit hyperkeratosis with a reduced or absent granular layer. Because AI has been linked to a variety of conditions, the workup of a patient presenting with this finding can be complex. We present an update on AI to provide clinicians with direction regarding the assessment and treatment of patients presenting with AI. An algorithm for the evaluation of patients presenting with AI is provided.
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Affiliation(s)
- Nisha Patel
- Georgetown University School of Medicine, Washington, USA
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Kodama K, Fink-Puches R, Massone C, Kerl H, Cerroni L. Papular mycosis fungoides: a new clinical variant of early mycosis fungoides. J Am Acad Dermatol 2006; 52:694-8. [PMID: 15793526 DOI: 10.1016/j.jaad.2004.12.018] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma. In early stages of the disease many different clinicopathologic variants have been observed. OBSERVATION We report 6 patients with early manifestations of MF characterized by the sole presence of papules which, unlike the papules of lymphomatoid papulosis, did not show a tendency for spontaneous resolution. Histologic examination confirmed the diagnosis of MF in all cases. Immunohistochemical staining for CD30 was negative in all cases. Follow-up data showed the nonaggressive behavior of the disease, confirming that the lesions were not manifestations of advanced MF. CONCLUSION Papular MF is a new variant of early MF characterized by the presence of papules in the absence of more conventional early lesions (patches) of the disease. This variant should be added to the long list of clinicopathologic subtypes of MF.
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Affiliation(s)
- Kazuo Kodama
- Department of Dermatology, Medical University of Graz, Graz, Austria
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Abstract
Paraneoplastic syndromes are a group of clinical manifestations associated with a malignancy, but not directly related to the primary tumor itself or to its metastases. Characteristically, they follow a course parallel to the tumor, resolve with successful treatment of the primary tumor, and tend to recur with its relapse or the onset of metastases. The mechanism by which they occur is not well understood, but may be related to the production of bioactive substances by or in response to the tumor, such as polypeptide hormones, hormone-like peptides, antibodies or immune complexes, cytokines, or growth factors.
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Affiliation(s)
- Isabelle Thomas
- Department of Dermatology, New Jersey Medical School, Newark, 07103-2714, USA
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Sato M, Sohara M, Kitamura Y, Hatamochi A, Yamazaki S. Ichthyosiform mycosis fungoides: report of a case associated with IgA nephropathy. Dermatology 2005; 210:324-8. [PMID: 15942221 DOI: 10.1159/000084759] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2004] [Accepted: 09/04/2004] [Indexed: 11/19/2022] Open
Abstract
We report a case of ichthyosiform mycosis fungoides (MF) associated with IgA nephropathy. Histological examination showed a dense atypical lymphocytic infiltrate admixed with epithelioid cells and giant cells in the dermis associated with the features of epidermotropism and folliculotropism. Reported cases of ichthyosiform MF are reviewed and histopathological characters of ichthyosiform MF are summarized. We suggest a histiocyte/dendritic-cell-rich infiltrate, or granulomatous features of infiltrate may be another characteristic of ichthyosiform MF. This case was associated with IgA nephropathy, which is uncommon. Such a presentation has never been reported in the literature.
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Affiliation(s)
- Madoka Sato
- Department of Dermatology, Dokkyo University School of Medicine, Tochigi, Japan.
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Abstract
Cutaneous lymphomas represent a heterogeneous group of T-, NK- and B-cell neoplasms, with mycosis fungoides (MF) being the most common subtype. MF has a plethora of clinicopathological manifestations. Many variants of this lymphoma differ substantially from the 'classical' Alibert-Bazin disease and are therefore sometimes referred to as 'atypical' forms of the disease. This review addresses the whole clinicopathological spectrum of mycosis fungoides with respect to epidemiology, clinical, histopathological, immunophenotypic and genotypic features and the clinical course and prognosis of its variants: classical, erythrodermic, follicular, syringotropic, bullous/vesicular, granulomatous, poikilodermic, hypo- and hyperpigmented, unilesional, palmoplantar, hyperkeratotic/verrucous, vegetating/papillomatous, ichthyosiform, pigmented purpura-like, pustular and mucosal involvement in MF.
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Affiliation(s)
- D V Kazakov
- Sikl's Department of Pathology, Charles University, Medical Faculty Hospital, Alej Svobody 80, Pilsen 30460, Czech Republic
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Hodak E, Amitay I, Feinmesser M, Aviram A, David M. Ichthyosiform mycosis fungoides: An atypical variant of cutaneous T-cell lymphoma. J Am Acad Dermatol 2004; 50:368-74. [PMID: 14988677 DOI: 10.1016/j.jaad.2003.10.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Acquired ichthyosis is a known paraneoplastic sign of lymphoproliferative malignancies, with histopathologic findings that are nonspecific, revealing no insinuation of the underlying neoplasm. Ichthyosiform eruption as a specific manifestation of mycosis fungoides (MF), ie, ichthyosiform MF, is, however, regarded as rare and to date has been reported in only a few cases. OBJECTIVE We sought to study the clinical, histopathologic, immunohistochemical, and genotypic features of patients with ichthyosiform MF. METHODS The files of patients with MF seen during the past 8 years in our department were reviewed to search for cases of ichthyosis-like MF. RESULTS Seven patients, comprising 3.5% of the patients seen with MF, had an ichthyosiform eruption with histopathologic features characteristic of early MF. In 2 patients it was the sole manifestation of the disease and in 5 patients it appeared either in conjunction with conventional patches and/or plaques or with follicular lesions. Immunohistochemically, all showed a predominance of CD3+ CD4+, except for 1 patient in whom the epidermotropic T cells were predominantly CD8+. In 3 of the 7 patients clonality could be demonstrated by polymerase chain reaction. None had extracutaneous involvement. All had an indolent course of the disease and responded well to skin-targeted therapies. CONCLUSIONS Ichthyosiform MF is yet another atypical clinical variant of cutaneous T-cell lymphoma that is not as rare as reflected in the literature. It may be the sole manifestation of the disease but also may appear in conjunction with conventional or follicular MF lesions.
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Affiliation(s)
- Emmilia Hodak
- Department of Dermatology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel 49100.
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Eisman S, O'Toole EA, Jones A, Whittaker SJ. Granulomatous mycosis fungoides presenting as an acquired ichthyosis. Clin Exp Dermatol 2003; 28:174-6. [PMID: 12653708 DOI: 10.1046/j.1365-2230.2003.01224.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We report a case of a 69-year-old gentleman who presented with a 3-month history of unexplained fevers and malaise who developed generalized pruritus, alopecia and an ichthyosiform erythematous eruption on his forearms, legs, chest and back. Skin histology, immunophenotyping and molecular features were consistent with granulomatous mycosis fungoides. He has been successfully treated with twice weekly PUVA photochemotherapy.
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Affiliation(s)
- S Eisman
- Department of Dermatology, Royal Free Hospital, London, UK.
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24
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Affiliation(s)
- E J Lowenstein
- Departments of Dermatology and Pathology, Mount Sinai Medical Center, New York, NY 10029, USA
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25
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Affiliation(s)
- D Rudikoff
- Department of Dermatology, Mount Sinai Medical Center, New York, New York 10029-6574, USA
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