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Nur Zafirah Z, Abdul Hadi A. Beyond the pale: Insights into hypopigmented mycosis fungoides - A case report. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2024; 19:47. [PMID: 39220235 PMCID: PMC11366274 DOI: 10.51866/cr.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Hypopigmented mycosis fungoides (MF) is a rare variant of cutaneous T-cell lymphoma, a type of extranodal non-Hodgkin lymphoma. This report presents the case of a 9-year-old boy with a 2-year history of asymptomatic, hypopigmented skin lesions that were resistant to topical treatment. He was initially treated for a fungal skin infection and had received multiple courses of topical antifungals and steroids but showed no improvement, which led to further evaluation and a referral to a dermatologist. A skin biopsy was performed, and the diagnosis of hypopigmented MF was confirmed through skin histopathology and immunohistochemistry study. His lesions responded well to cycles of narrowband ultraviolet B phototherapy, showing almost complete clearance after 4 months without any side effects.
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Affiliation(s)
- Zauddin Nur Zafirah
- MBBS, Department of Family Medicine, Faculty of Medicine , International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Kuantan, Pahang, Malaysia.
| | - Azwanis Abdul Hadi
- MBChB, M.Med (FamMed), Department of Family Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Kuantan, Pahang, Malaysia
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Atci T, Ozturk Sari S, Buyukbabani N, Besisik S, Baykal C. Evaluation of the prognostic significance of clinical features of tumoral lesions in an extensive series of mycosis fungoides. Int J Dermatol 2024. [PMID: 38440839 DOI: 10.1111/ijd.17120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/31/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Tumors indicating the advanced stage of mycosis fungoides (MF) have a rich clinical spectrum. Although it is known that the prognosis of MF generally worsens following the development of tumors, some cases may have a relatively indolent course, and the role of clinical characteristics regarding prognosis has still not been well understood. METHODS MF patients were retrospectively evaluated regarding the development of tumors. Besides demographic characteristics, data of the subtype and stage of the disease were recorded. The clinical features of tumors, including number (<5, 5-10, 11-20, or >20), location, dimension (diameter of ≥5 cm), presence of ulceration, and surrounding inflammation, were noted. Univariate and multivariate analyses evaluated the relationship between overall survival (OS) with demographic and clinical features. RESULTS Among 730 consecutive MF patients, tumors developed in 8.2% (n = 60), of whom 46.7% were diagnosed with advanced-stage MF from the beginning. The most common subtype was folliculotropic MF (53.3%). Most patients (55%) had multiple tumors, and the most frequent localization was the trunk (71.7%). Most tumors presented as smooth-surfaced, indurated papules and/or nodules (70%), while others were reddish-purple, occasionally accompanied by ulceration (50%), perilesional inflammation (23.3%), and attaining large dimensions (25%). Mortality was recorded in 51.7% of patients, and the 5-year OS rate from the diagnosis of tumors was 49%. Independent poor prognostic factors for OS in multivariate analysis included older age at the time of diagnosis, presence of tumors at the initial MF diagnosis, presence of over 20 tumors, and the existence of large tumors. CONCLUSIONS Tumoral MF seen in older patients, the first diagnosis of MF in this stage, presenting with generalized and large tumors, seems to be a predictive factor for OS.
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Affiliation(s)
- Tugba Atci
- Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Sule Ozturk Sari
- Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Nesimi Buyukbabani
- Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
- Department of Pathology, Koc University Medical Faculty, Istanbul, Turkey
| | - Sevgi Besisik
- Department of Hematology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Can Baykal
- Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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Miyashiro D, Sanches JA. Mycosis fungoides and Sézary syndrome: clinical presentation, diagnosis, staging, and therapeutic management. Front Oncol 2023; 13:1141108. [PMID: 37124514 PMCID: PMC10140754 DOI: 10.3389/fonc.2023.1141108] [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: 01/10/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Mycosis fungoides (MF) and Sézary syndrome (SS) are cutaneous T-cell lymphomas. MF is the most common cutaneous lymphoma, and it is classified into classic Alibert-Bazin MF, folliculotropic MF, pagetoid reticulosis, and granulomatous slack skin, each with characteristic clinical presentation, histopathological findings, and distinct clinical behaviors. SS is an aggressive leukemic variant of cutaneous lymphoma, and it is characterized by erythroderma, lymphadenopathy, and peripheral blood involvement by malignant cells. There is a wide range of dermatological manifestations of MF/SS, and prompt recognition is essential for early diagnosis. Skin biopsy for histopathology and immunohistochemical analysis is imperative to confirm the diagnosis of MF/SS. Histopathology may also provide information that may influence prognosis and treatment. Staging follows the TNMB system. Besides advanced stage, other factors associated with poorer prognosis are advanced age, male gender, folliculotropism in histopathology of patients with infiltrated plaques and tumors in the head and neck region, large cell transformation, and elevated lactate dehydrogenase. Treatment is divided into skin-directed therapies (topical treatments, phototherapy, radiotherapy), and systemic therapies (biological response modifiers, targeted therapies, chemotherapy). Allogeneic bone marrow transplantation and extracorporeal photopheresis are other treatment modalities used in selected cases. This review discusses the main clinical characteristics, the histopathological/immunohistochemical findings, the staging system, and the therapeutic management of MF/SS.
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Tissue levels of suppressor of cytokine signaling-3 (SOCS-3) in mycosis fungoides. Arch Dermatol Res 2023; 315:165-171. [PMID: 35226171 PMCID: PMC9938809 DOI: 10.1007/s00403-022-02339-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 12/25/2021] [Accepted: 02/15/2022] [Indexed: 11/02/2022]
Abstract
Mycosis fungoides (MF) is a type of cutaneous T-cell lymphoma with proposed multifactorial etiology. Suppressor of cytokine signaling-3 (SOCS-3) is one of the proteins expressed in MF. Its exact role in disease pathogenesis has not yet been thoroughly investigated. This study aimed to assess the expression of SOCS-3 in patients' skin with mycosis fungoides to elucidate their possible role in the pathogenesis in MF. 30 patients with mycosis fungoides and 30 age and sex-matched healthy controls were included. After clinical examination, tissue levels of SOCS-3 were measured by ELISA. The level of expression of SOCS-3 was significantly upregulated in the lesional tissue compared to perilesional SOCS-3 level in patients' group (P < 0.001), and both levels were higher than the SOCS-3 level in control group (P < 0.001). In addition, there was a statistically significant positive correlation between lesional SOCS-3 level and itching in patients' group (P < 0.001). Regarding lesional and perilesional SOCS-3 levels in each stage, there was a significant increase in lesional SOCS-3 levels in comparison to perilesional level whether in stage Ia, Ib, and IIa; (P < 0.001), (P < 0.001) and (P < 0.001), respectively. Increased tissue levels of SOCS-3 patients with mycosis fungoides point to a role that SOCS-3 could play in its pathogenesis. Also, high levels of SOCS-3 in MF patients with itching suggest a role in the pathogenesis of this symptom. These findings may prove helpful in formulating a new treatment modality in addition to the current treatment of MF.
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Brown-Korsah JB, McKenzie S, Omar D, Syder NC, Elbuluk N, Taylor SC. Variations in genetics, biology, and phenotype of cutaneous disorders in skin of color - Part I: Genetic, biologic, and structural differences in skin of color. J Am Acad Dermatol 2022; 87:1239-1258. [PMID: 35809800 DOI: 10.1016/j.jaad.2022.06.1193] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/27/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022]
Abstract
Skin of color (SOC) populations include those who identify as Black/African, Hispanic/Latinx, Asian/Pacific Islander, American Indian/Native Alaskan, Indigenous Australian, Middle Eastern, biracial/multiracial, or non-White; this list is far from exhaustive and may vary between and within cultures. Recent genetic and immunological studies have suggested that cutaneous inflammatory disorders (atopic dermatitis, psoriasis, and hidradenitis suppurativa) and malignancies (melanoma, basal cell carcinoma, and cutaneous T-cell lymphoma) may have variations in their immunophenotype among SOC. Additionally, there is growing recognition of the substantial role social determinants of health play in driving health inequalities in SOC communities. It is critically important to understand that social determinants of health often play a larger role than biologic or genetic factors attributed to "race" in health care outcomes. Herein, we describe the structural, genetic, and immunological variations and the potential implications of these variations in populations with SOC. This article underscores the importance of increasing the number of large, robust genetic studies of cutaneous disorders in SOC to create more targeted, effective therapies for this often underserved and understudied population. Part II of this CME will highlight the clinical differences in the phenotypic presentation of and the health disparities associated with the aforementioned cutaneous disorders in SOC.
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Affiliation(s)
- Jessica B Brown-Korsah
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Case Western Reserve University, School of Medicine, Cleveland, Ohio
| | - Shanice McKenzie
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Deega Omar
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; George Washington University, School of Medicine and Health Sciences, Washington, District of Columbia
| | - Nicole C Syder
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Nada Elbuluk
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
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Miyashiro D, Sanches JA. Characteristics and outcomes of 727 patients with mycosis fungoides and Sézary syndrome from a Brazilian cohort. Int J Dermatol 2021; 61:442-454. [PMID: 34435672 DOI: 10.1111/ijd.15865] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mycosis fungoides (MF) and Sézary syndrome (SS) are the most prevalent cutaneous lymphomas. They were not described in a large Brazilian cohort yet. We aimed, with this single-center, retrospective cohort analysis, to describe the characteristics and outcomes of MF/SS in a tertiary public health service in Brazil. METHODS MF/SS patients evaluated at the University of São Paulo Medical School between 1989 and 2018 were included. Data were collected at diagnosis. Demographic, clinical, histopathological, immunopathological, molecular, laboratory, and follow-up data were analyzed. RESULTS Among 727 patients, 92.6% (673) were diagnosed with MF, 7.4% (54) with SS. There were 51.2% (372) of males, 48.8% (355) of females. The median age was 51.8 years; it was higher in erythrodermic MF (60.2) and SS (60.9). Among MF, 41.8% (281) had classic MF, 4.9% (33) folliculotropic MF, 1.8% (12) granulomatous slack skin, and 0.3% (2) pagetoid reticulosis. Common subtypes included erythrodermic (14.1%, 95), hypopigmented (10.8%, 73), and poikilodermatous MF (10.8%, 73). Extracutaneous involvement was rare. Five, 10, 20, and 30-year overall survival rates were 97.3%, 92.4%, 82.6%, and 82.6% for early-stage, and 58.6%, 42.7%, 20.8%, and 15.4% for advanced-stage disease, respectively. After multivariate analysis, SS diagnosis, folliculotropic MF, erythrodermic MF, clinical stage, age (≥60 years), increased lactate dehydrogenase, and large cell transformation conferred poorer prognosis. CONCLUSIONS We observed a higher percentage of hypopigmented MF compared to the literature, and demographic (older age) and prognostic (poorer prognosis) similarities between erythrodermic MF and SS, suggesting a possible relationship between these erythrodermic lymphomas. Factors associated with a poorer prognosis were compatible with the literature.
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Affiliation(s)
- Denis Miyashiro
- Division of Clinical Dermatology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - José A Sanches
- Division of Clinical Dermatology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
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O'Donnell M, Zaya R, Correia E, Krishnasamy S, Sahu J, Shi W, Cha J, Alpdogan SO, Porcu P, Nikbakht N. Disease characteristics, prognosis, and response to therapy in patients with large-cell transformed mycosis fungoides: A single-center retrospective study. J Am Acad Dermatol 2021; 86:1285-1292. [PMID: 34273458 DOI: 10.1016/j.jaad.2021.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 07/01/2021] [Accepted: 07/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mycosis fungoides with large-cell transformation (MF-LCT) is associated with an aggressive clinical course, yet data comparing treatment outcomes in MF-LCT are sparse. OBJECTIVE To compare treatment outcomes and to determine disease prevalence and characteristics associated with survival in MF-LCT. METHODS A retrospective review was conducted of mycosis fungoides patients from 2012 to 2020 treated at Thomas Jefferson University. Patients with histopathologic diagnosis of MF-LCT were included. Treatment outcomes were assessed by mean changes in the modified Severity Weighted Assessment Tool (mSWAT) and stage. RESULTS Of 171 patients with mycosis fungoides, 23 (13.4%) had histologic diagnosis of MF-LCT. The overall 5-year survival rate for MF-LCT was 74% and was not significantly associated with sex, age, or initial stage at the time of MF-LCT diagnosis. Brentuximab vedotin showed the greatest mean decrease in mSWAT (-20.53) and stage progression (change in Δ stage: -0.4) in MF-LCT compared to oral bexarotene (ΔmSWAT: +4.51; Δstage: +0.27), skin-directed therapy (ΔmSWAT: -5.93; Δstage: -0.08), and chemotherapy (ΔmSWAT: +4.97; Δstage: +0.85). LIMITATIONS Single-center retrospective design, and patients often on multiple treatment modalities. CONCLUSIONS We report superior treatment outcomes for brentuximab vedotin compared to oral bexarotene, skin-directed therapy, and chemotherapy in MF-LCT in both early and advanced disease.
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Affiliation(s)
- Megan O'Donnell
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennysylvania
| | - Romsin Zaya
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennysylvania
| | - Emily Correia
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennysylvania
| | - Shalini Krishnasamy
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennysylvania; Department of Hematology & Oncology, Thomas Jefferson University, Philadelphia, Pennysylvania
| | - Joya Sahu
- Dermatology Specialists of Alabama, Madison, Alabama
| | - Wenyin Shi
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennysylvania
| | - Jisun Cha
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennysylvania
| | | | - Pierluigi Porcu
- Department of Hematology & Oncology, Thomas Jefferson University, Philadelphia, Pennysylvania
| | - Neda Nikbakht
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennysylvania.
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Clinical characteristics and long-term outcome of 223 patients with mycosis fungoides at a single tertiary center in Korea: A 29-year review. J Am Acad Dermatol 2021; 86:1275-1284. [PMID: 34197872 DOI: 10.1016/j.jaad.2021.06.860] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 06/16/2021] [Accepted: 06/20/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Data regarding Asian patients with mycosis fungoides (MF) are limited. OBJECTIVE We aimed to investigate the clinical profile and long-term outcomes of patients with MF in Korea. METHODS A retrospective review of 223 patients with MF who were followed up for more than 6 months or died of MF within 6 months of diagnosis was performed. RESULTS Approximately 96.4% and 3.6% of the patients had an early stage and advanced stage, respectively. The mean age at diagnosis was 44.8 years. The mean duration of symptoms before diagnosis was 47.0 months. Various subtypes were noted, including mycosis fungoides palmaris et plantaris (21.5%), folliculotropic (8.5%), pityriasis lichenoides-like (6.7%), ichthyosiform (4.0%), lichenoid purpura-like (2.7%), and hypopigmented (2.2%) MF. Juvenile patients accounted for 16.6%. The higher the skin T stage, the poorer the response to treatment. The 10-year overall survival was 96.8% in early-stage patients and 25.0% in advanced-stage patients. General prognosis was favorable, while recurrence and subtype switching were seen in 29.4% and 2.7% of patients, respectively. LIMITATIONS Our patients may not represent all Korean patients with MF. CONCLUSION MF in Korea has a high proportion of variants, a younger age at onset, and favorable prognosis. A high index of suspicion and skin biopsy are needed for early diagnosis.
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Primary Cutaneous Lymphomas in Thailand: A 10-Year Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:4057661. [PMID: 34235215 PMCID: PMC8216793 DOI: 10.1155/2021/4057661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/24/2021] [Indexed: 11/24/2022]
Abstract
Background Primary cutaneous lymphomas (PCLs) refer to cutaneous lymphomas that primarily develop in the skin with no evidence of extracutaneous disease at the time of diagnosis. The epidemiological and clinical data of PCLs in Thailand are lacking. Objectives To evaluate the frequency, demographic data, and clinical characteristics of different subtypes of PCLs in a tertiary care university hospital. Methods In total, 137 patients with PCLs diagnosed in our hospital in 2008–2017 were retrospectively reviewed. Results Of the 137 patients, 57 (41.6%) were male and 80 (58.4%) were female (M : F = 1 : 1.4). The median age at diagnosis was 40 years. Most patients (134, 97.8%) had cutaneous T-cell lymphomas (CTCLs). Three patients (2.2%) had cutaneous B-cell lymphomas (CBCLs). The most common subtype was mycosis fungoides (MF) (67.9%), followed by subcutaneous panniculitis-like T-cell lymphoma (SPTCL) (21.2%), primary cutaneous anaplastic large cell lymphoma (pcALCL) (3.6%), lymphomatoid papulosis (LyP) (1.5%), primary cutaneous gamma/delta T-cell lymphoma (pcGDTCL) (1.5%), Sézary syndrome (SS) (0.7%), extranodal NK/T-cell lymphoma, nasal type (ENKTCL-NT) (0.7%), primary cutaneous peripheral T-cell lymphoma, not otherwise specified (pcPTCL-NOS) (0.7%), primary cutaneous diffuse large B-cell lymphoma, leg type (pcDLBCL-LT) (1.5%), and primary cutaneous follicle center lymphoma (pcFCL) (0.7%). Most patients with MF presented with early-stage disease (84.0%), with hypopigmented MF the most common variant (42.6%). Conclusions Compared to earlier Caucasian and Asian studies, the present study revealed a higher proportion of CTCL patients with a younger age at onset and a female predominance. MF was the most common CTCL subtype, followed by SPTCL. More than 80% of MF patients were diagnosed at an early stage.
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Moon IJ, Lee KH, Choi JW, Lee WJ, Won CH, Chang S, Choi JH, Lee MW. Clinical characteristics and long-term outcomes of 97 Korean patients with mycosis fungoides. Int J Dermatol 2021; 60:1510-1519. [PMID: 33991105 DOI: 10.1111/ijd.15561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/27/2021] [Accepted: 03/17/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Mycosis fungoides (MF) shows racial and regional differences in terms of clinical features. The availability of therapeutic options as well as drugs differs from one country to another. There are only limited data on the clinical characteristics and treatment experience of MF from South Korea. METHODS Medical records of 97 patients with MF were retrospectively analyzed to investigate clinical features, survivals, and prognostic factors. Assessment of prognostic variables was done using univariate Cox proportional hazard models. RESULTS Median age at time of diagnosis was 45 years. The median time from onset of skin lesion to diagnosis of MF was 36 months with a median follow-up period of 96 months. A number of clinical variants of MF were observed. Treatment mainly consisted of narrow-band UVB, systemic retinoids, methotrexate, chemotherapy, and regional radiotherapy. Complete remission was observed in 78% of patients with records on their clinical course. About 12% experienced disease progression. No clinical prognostic factor apart from TNM staging was identified. CONCLUSION Despite delay in diagnosis, most cases of MF in Korea were diagnosed in early stages. Prognosis of our patients was more favorable than those of other geographic regions as reported in previous studies. Good response to treatment, consisting mainly of phototherapy and radiation therapy, and relatively indolent clinical behavior of disease were observed in this homogeneous cohort of Korean patients with MF.
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Affiliation(s)
- Ik Jun Moon
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Keon Hee Lee
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jae Won Choi
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Woo Jin Lee
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Chong Hyun Won
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sungeun Chang
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jee Ho Choi
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Mi Woo Lee
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Rattanakaemakorn P, Ploydaeng M, Udompanich S, Thadanipon K, Rutnin S, Rajatanavin N. Phototherapy as a treatment of early-stage mycosis fungoides and predictive factors for disease recurrence: A 17-year retrospective study. Indian J Dermatol Venereol Leprol 2021; 87:645-650. [PMID: 33871205 DOI: 10.25259/ijdvl_555_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/01/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Mycosis fungoides is the most common form of cutaneous T-cell lymphoma. Narrowband ultraviolet B and psoralen and ultraviolet A are effective treatment options, but studies of their treatment efficacy and disease relapse remain limited. OBJECTIVES This study aimed (1) to determine the efficacy of narrowband ultraviolet B and psoralen and ultraviolet A as a treatment for early-stage mycosis fungoides and explore the predictive factors for complete remission and (2) to determine the relapse rate and analyze their predictive factors, including the utility of maintenance therapy. METHODS This was a retrospective cohort study consisting of 61 patients with early-stage mycosis fungoides (IA - IB) treated with narrowband ultraviolet B or psoralen and ultraviolet A as the first-line therapy from January 2002 to December 2018 at the Division of Dermatology, Ramathibodi Hospital, Bangkok, Thailand. Cox regression analysis and Kaplan-Meier survival curve were performed for the main outcomes. RESULTS A complete remission was achieved by 57 (93.5%) patients. The median time to remission was 7.80 ± 0.27 months. Types of phototherapy (narrowband ultraviolet B or psoralen and ultraviolet A), age and gender did not associate with time to remission, while the presence of poikiloderma and higher disease stage led to a longer time to remission. The cumulative incidence of relapse was 50.8%. The median time to relapse was 24.78 ± 5.48 months. In patients receiving phototherapy during the maintenance period, a treatment duration longer than six months was associated with a significantly longer relapse-free interval. CONCLUSION Narrow-band-ultraviolet B and psoralen and ultraviolet A are effective treatment options for early-stage mycosis fungoides. Maintenance treatment by phototherapy for at least six months seems to prolong remission.
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Affiliation(s)
- Ploysyne Rattanakaemakorn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Monthanat Ploydaeng
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Siriorn Udompanich
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kunlawat Thadanipon
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suthinee Rutnin
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Natta Rajatanavin
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Gender differences in clinical presentation, treatment, and outcomes in mycosis fungoides. J Am Acad Dermatol 2021; 86:174-177. [PMID: 33465428 DOI: 10.1016/j.jaad.2021.01.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/30/2020] [Accepted: 01/07/2021] [Indexed: 11/22/2022]
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Cheng HM, Tee SI, Tan WP. Mycosis fungoides associated with silicone injections. Australas J Dermatol 2020; 62:237-238. [PMID: 33070324 DOI: 10.1111/ajd.13494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/19/2020] [Accepted: 09/23/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Hui Mei Cheng
- Department of Dermatology, National Skin Centre, Singapore, Singapore
| | - Shang-Ian Tee
- Department of Dermatology, National Skin Centre, Singapore, Singapore
| | - Wee Ping Tan
- Department of Dermatology, National Skin Centre, Singapore, Singapore
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Kaul S, Belzberg M, Hughes JDM, Mahadevan V, Khanna R, Bakhshi PR, Hong MS, Williams KA, Grossberg AL, Kwatra SG, Sweren RJ. Comorbidities in Mycosis Fungoides and Racial Differences in Co-Existent Lymphomatoid Papulosis: A Cross-Sectional Study of 580 Patients in an Urban Tertiary Care Center. MEDICINES (BASEL, SWITZERLAND) 2019; 7:E1. [PMID: 31888015 PMCID: PMC7168128 DOI: 10.3390/medicines7010001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 12/10/2019] [Accepted: 12/24/2019] [Indexed: 12/22/2022]
Abstract
Background: Mycosis fungoides (MF) is a cutaneous T-cell lymphoma. Previous reports have suggested MF is associated with inflammatory conditions such as psoriasis, increased cardiovascular risk factors as well as secondary neoplasms. Methods: A cross-sectional study of MF patients seen from 2013 to 2019 was performed. Comorbidities were selected based on the 2015 Medicare report highlighting the most common chronic medical illnesses in the United States. Lifetime comorbidity occurrence in patients with MF were compared with that in patients with atopic dermatitis, psoriasis and patients without MF. Additional analyses were performed with patients sub-stratified by race. Results: Compared to control groups, MF was strongly associated with lymphomatoid papulosis and Hodgkin's disease, but not significantly associated with lung, breast or colon cancer. Interestingly, the association with lymphomatoid papulosis was observed in Caucasians (CI 1062-4338; p < 0.001) and not African Americans (p = 0.9). Patients with MF had a greater association with congestive heart failure, hypertension (HT) and hyperlipidemia (HLD) compared with the general population. However, they were significantly less likely to have HT and HLD when compared with psoriasis patients (HT CI: 0.6-0.9; p < 0.001, and HLD CI: 0.05-0.07; p < 0.001). MF patients were also significantly less likely to have concomitant vitamin D deficiency compared with atopic dermatitis (AD) and psoriasis (p < 0.001). Conclusions: Our results suggest that the association of MF with lymphomatoid papulosis varies by race. Compared to the general population, hypertension and hyperlipidemia were positively associated with MF, however, these were significantly less likely on comparison to psoriasis. Unlike previously described, vitamin D deficiency was found to be significantly less in patients with MF.
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Affiliation(s)
- Subuhi Kaul
- Department of Medicine, John H. Stroger Hospital of Cook County, Chicago, IL 60612, USA
| | - Micah Belzberg
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (M.B.); (V.M.); (R.K.); (P.R.B.); (M.S.H.); (K.A.W.); (A.L.G.); (S.G.K.); (R.J.S.)
| | | | - Varun Mahadevan
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (M.B.); (V.M.); (R.K.); (P.R.B.); (M.S.H.); (K.A.W.); (A.L.G.); (S.G.K.); (R.J.S.)
| | - Raveena Khanna
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (M.B.); (V.M.); (R.K.); (P.R.B.); (M.S.H.); (K.A.W.); (A.L.G.); (S.G.K.); (R.J.S.)
| | - Pegah R. Bakhshi
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (M.B.); (V.M.); (R.K.); (P.R.B.); (M.S.H.); (K.A.W.); (A.L.G.); (S.G.K.); (R.J.S.)
| | - Michael S. Hong
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (M.B.); (V.M.); (R.K.); (P.R.B.); (M.S.H.); (K.A.W.); (A.L.G.); (S.G.K.); (R.J.S.)
| | - Kyle A. Williams
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (M.B.); (V.M.); (R.K.); (P.R.B.); (M.S.H.); (K.A.W.); (A.L.G.); (S.G.K.); (R.J.S.)
| | - Annie L. Grossberg
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (M.B.); (V.M.); (R.K.); (P.R.B.); (M.S.H.); (K.A.W.); (A.L.G.); (S.G.K.); (R.J.S.)
| | - Shawn G. Kwatra
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (M.B.); (V.M.); (R.K.); (P.R.B.); (M.S.H.); (K.A.W.); (A.L.G.); (S.G.K.); (R.J.S.)
| | - Ronald J. Sweren
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (M.B.); (V.M.); (R.K.); (P.R.B.); (M.S.H.); (K.A.W.); (A.L.G.); (S.G.K.); (R.J.S.)
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15
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Sidiropoulou P, Nikolaou V, Marinos L, Voudouri D, Komini E, Economidi A, Rigopoulos D, Stratigos A. The different faces of mycosis fungoides: results of a single‐center study. Int J Dermatol 2019; 59:314-320. [DOI: 10.1111/ijd.14735] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 10/21/2019] [Accepted: 11/05/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Polytimi Sidiropoulou
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
| | - Vasiliki Nikolaou
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
| | - Leonidas Marinos
- Hematopathology Department “Evangelismos” General Hospital Athens Greece
| | - Dimitra Voudouri
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
| | - Elena Komini
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
| | - Afroditi Economidi
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
| | - Dimitris Rigopoulos
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
| | - Alexander Stratigos
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
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16
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Shi HZ, Liu YX, Jiang YQ, Chen SL, Xu XL, Lu XM, Zhang W, Zeng XS, Zhou GZ, Sun JF, Chen H. Clinical characteristics of primary cutaneous lymphoma: analysis from two centres in China. Br J Dermatol 2019; 181:1332-1333. [PMID: 31260087 DOI: 10.1111/bjd.18266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- H-Z Shi
- Department of Pathology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Y-X Liu
- Department of Pathology, Shandong Provincial Institute of Dermatology and Venereology, Jinan, China
| | - Y-Q Jiang
- Department of Pathology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - S-L Chen
- Department of Pathology, Shandong Provincial Institute of Dermatology and Venereology, Jinan, China
| | - X-L Xu
- Department of Pathology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - X-M Lu
- Department of Pathology, Shandong Provincial Institute of Dermatology and Venereology, Jinan, China
| | - W Zhang
- Department of Pathology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - X-S Zeng
- Department of Pathology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - G-Z Zhou
- Department of Pathology, Shandong Provincial Institute of Dermatology and Venereology, Jinan, China
| | - J-F Sun
- Department of Pathology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - H Chen
- Department of Pathology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
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