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McFeely O, Walsh PM, Desmond R, Enright H, Costa Blasco M, Wolinska A, Murphy L, Andrawis M, Beatty P, Doyle C, Tobin AM, O'Gorman S, Molloy K. Incidence of cutaneous T-cell lymphoma in the Republic of Ireland between 1994 and 2019. J Eur Acad Dermatol Venereol 2024; 38:e145-e147. [PMID: 37705380 DOI: 10.1111/jdv.19497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023]
Affiliation(s)
- O McFeely
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - P M Walsh
- National Cancer Registry of Ireland, Cork, Ireland
| | - R Desmond
- Department of Haematology, Tallaght University Hospital, Dublin, Ireland
| | - H Enright
- Department of Haematology, Tallaght University Hospital, Dublin, Ireland
| | - M Costa Blasco
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - A Wolinska
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - L Murphy
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - M Andrawis
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - P Beatty
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - C Doyle
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - A M Tobin
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - S O'Gorman
- Department of Dermatology, St. James's Hospital, Dublin, Ireland
| | - K Molloy
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
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2
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Wu Y, Kang K, Sun X, Niu T, Zhao A. Increased risk of sepsis-caused death in Black patients with primary cutaneous T-cell lymphoma and Burkitt lymphoma: A population study of the US SEER registry. J Am Acad Dermatol 2024; 90:e75-e78. [PMID: 37802184 DOI: 10.1016/j.jaad.2023.08.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/28/2023] [Accepted: 08/12/2023] [Indexed: 10/08/2023]
Affiliation(s)
- Yijun Wu
- Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kai Kang
- Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xu Sun
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ting Niu
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Ailin Zhao
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Navarro Matilla B, Ortiz Romero PL, Pujol Vallverdú RM, Combalia Escudero A, Zapata Paz I, González Barca E, Muniesa Montserrat C, Morillo Andújar M, Pérez Ferriols A, Román Curto C, Fernández de Misa Cabrera R, Hospital Gil M, Marín Niebla A, Rios Rull PJ, de la Cruz Vicente F, Izu Belloso RM, Martín García-Sancho A, Parera Amer ME, Córdoba Mascuñano R, Ramón Quiles MD, Saus Carreres A, Del Campo García R, Machan S, Viguera Ester P, Blanco Garnelo J. Cost of Treating Cutaneous T-Cell Lymphoma in Spain: Analysis of MICADOS Study Data by Disease Stage. Actas Dermosifiliogr 2024; 115:119-129. [PMID: 37689349 DOI: 10.1016/j.ad.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The cost of treating cutaneous T-cell lymphoma (CTCL) in Spain is unknown. With the advent of new treatments, it is more important than ever to gain an accurate picture of the true costs involved. The MICADOS study had 2 primary objectives: 1)to evaluate the impact of CTCL on patient quality of life, and 2)to evaluate the costs associated with the disease. This article reports the results of the cost analysis. METHODS We estimated the cost of treating CTCL over a period of 1year from the perspective of the Spanish National Health System. Twenty-three dermatologists and hematologists from 15 public hospitals analyzed data for adult patients with mycosis fungoides (MF) or Sézary syndrome (SS). RESULTS A total of 141 patients (57.4% male) with a mean age of 63.6 years (95%CI: 61.4-65.7 years) were included. The mean direct annual cost of treating CTCL was €34,214 per patient. The corresponding costs by stage were €11,952.47 for stageI disease, €23,506.21 for stageII disease, €38,771.81 for stageIII disease, and €72,748.84 for stageIV disease. The total direct annual cost of treating MF/SS in public hospitals in Spain was estimated at €78,301,171; stageI disease accounted for 81% of all costs, stageII for 7%, and stagesIII andIV for 6% each. CONCLUSIONS The MICADOS study offers an accurate picture of the direct cost of treating CTCL in patients with MF/SS in Spain and shows that costs vary significantly according to disease stage. Patient-borne and indirect costs should be analyzed in future studies.
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Affiliation(s)
- B Navarro Matilla
- Departamento de Hematología, Hospital Universitario Puerta de Hierro, Madrid, España
| | - P L Ortiz Romero
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | | | - A Combalia Escudero
- Departamento de Dermatología, Hospital Universitario Clínic i Provincial, Barcelona, España
| | - I Zapata Paz
- Departamento de Radiación Oncológica, Hospital Universitario Puerta de Hierro, Madrid, España
| | - E González Barca
- Departamento de Hematología, Institut Catalá d'Oncología, Hospitalet de Llobregat, Barcelona, España
| | - C Muniesa Montserrat
- Departamento de Dermatología, Hospital Universitario de Bellvitge, Barcelona, España
| | - M Morillo Andújar
- Departamento de Dermatología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - A Pérez Ferriols
- Departamento de Dermatología, Hospital General Universitario de Valencia, Valencia, España
| | - C Román Curto
- Departamento de Dermatología, Hospital General Universitario de Salamanca, Salamanca, España
| | - R Fernández de Misa Cabrera
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - M Hospital Gil
- Departamento de Dermatología, Hospital Universitario Puerta de Hierro, Madrid, España
| | - A Marín Niebla
- Departamento de Hematología, Hospital Universitario Vall d'Hebron/VHIO, Barcelona, España
| | - P J Rios Rull
- Departamento de Hematología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - F de la Cruz Vicente
- Departamento de Hematología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - R M Izu Belloso
- Departamento de Dermatología, Hospital de Basurto, Bilbao, España
| | - A Martín García-Sancho
- Departamento de Hematología, Hospital General Universitario de Salamanca, Salamanca, España
| | - M E Parera Amer
- Departamento de Dermatología, Hospital Son Llàtzer, Palma de Mallorca, España
| | - R Córdoba Mascuñano
- Departamento de Hematología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - M D Ramón Quiles
- Departamento de Dermatología, Hospital Clínico Universitario, Valencia, España
| | - A Saus Carreres
- Departamento de Hematología, Hospital Clínico Universitario, Valencia, España
| | - R Del Campo García
- Departamento de Hematología, Hospital Son Llàtzer, Palma de Mallorca, España
| | - S Machan
- Departamento de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - P Viguera Ester
- Departamento Médico, Kyowa Kirin Farmacéutica, S.L., Madrid, España
| | - J Blanco Garnelo
- Departamento Médico, Kyowa Kirin Farmacéutica, S.L., Madrid, España.
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Ren Z, Chrisman LP, Pang Y, Nguyen M, Hooper MJ, LeWitt TM, Veon FL, Guitart J, Zhou XA. Chemical exposures and demographic associations in cutaneous T-cell lymphoma: a large single institution physician validated cohort study. Arch Dermatol Res 2024; 316:74. [PMID: 38236413 DOI: 10.1007/s00403-023-02799-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 10/17/2023] [Accepted: 12/13/2023] [Indexed: 01/19/2024]
Abstract
Cutaneous T-cell lymphomas (CTCL) are a rare group of T-cell neoplasms which infiltrate the skin and can result in substantial morbidity and mortality. Risk factors for CTCL are still poorly understood though recent studies suggest chemical exposures may play a role in its development. To further characterize patient-centered risk factors for CTCL, especially compared with matched controls, we performed one of the largest prospective cohort survey studies to date to examine patient-reported exposures and health-related quality of life (HRQoL) in association with concurrent clinical disease characteristics. Patient demographics, lifestyle factors, and chemical exposures were collected via clinical data and surveys. Descriptive statistics, ANOVA, Chi-square tests and t tests were utilized to compare patient-reported exposures and HRQoL in patients with CTCL versus matched healthy controls (HC). Statistically significant differences were identified between patients and HC in terms of race (non-white race 22.4% in CTCL patients vs. 18.8% in HC, P = 0.01), and education level (high school or less 41.6% in CTCL patients vs. 14.3% in HC, P = 0.001), but not with Fitzpatrick skin type (P = 0.11) or smoking status (P = 0.28). Notably, 36.0% of the CTCL patients reported exposures to chemicals, a near threefold increased percentage when compared to HC (12.9%). Among various chemical exposures, 27.0% of the CTCL patients specifically reported industrial chemical exposure, a more than two-fold increased percentage when compared to HC (12.9%). Itch and pain were significantly associated with skin disease severity (as evaluated by CTCL-specific mSWAT score) in advanced stage disease (stages IIB-IVB) (r = 0.48 and 0.57, P < 0.05). Itch and body mass index (BMI) were weakly associated with skin disease severity in early-stage disease (stages IA-IIA) (r = 0.27 and 0.20, P < 0.05).
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Affiliation(s)
- Ziyou Ren
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lauren P Chrisman
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Yanzhen Pang
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Morgan Nguyen
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Madeline J Hooper
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tessa M LeWitt
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Francesca L Veon
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joan Guitart
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Xiaolong A Zhou
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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Gordon ER, Adeuyan O, Schreidah CM, Chen C, Trager MH, Lapolla BA, Fahmy LM, Weng C, Geskin LJ. Clusters, crop dusters, and myth busters: a scoping review of environmental exposures and cutaneous T-cell lymphoma. Ital J Dermatol Venerol 2023; 158:467-482. [PMID: 38015484 DOI: 10.23736/s2784-8671.23.07729-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Cutaneous T-cell lymphoma (CTCL) is a heterogenous group of non-Hodgkin lymphomas. Similar presentation to benign conditions, significant genetic variation, and lack of definitive biomarkers contributes to diagnostic delay. The etiology of CTCL is unknown, and environmental exposures, such as geographic, occupational, chemicals, sunlight, and insects have been investigated. EVIDENCE ACQUISITION Review of the literature for CTCL and exposures was performed in PubMed and Google Scholar in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Extension for Scoping Reviews. This search yielded 193 total results, which were initially screened with defined inclusion and exclusion criteria. The 45 remaining articles were reviewed and classified by exposure type. EVIDENCE SYNTHESIS The most frequently investigated CTCL exposure type was geographic (13/45 articles, 29%). Chemical exposures were commonly discussed (10/45 articles, 22%), along with occupational (10/45 articles, 22%). Insect exposures (6/45, 13%) and sun exposure (3/45, 7%) were also reviewed, along with articles describing multiple exposure types (3/45, 7%). Article types ranged from cases to systematic reviews and case-control studies. Evidence linking CTCL and these exposures was mixed. Limitations of this investigation include reliance on patient reporting and frequent speculation on disease association versus causality. CONCLUSIONS This investigation synthesizes the current literature on exposures potentially implicated in the pathogenesis of CTCL, while offering guidance on patient history-taking to ensure potential exposures are captured. Awareness of these possible associations may improve understanding of disease pathogenesis and diagnosis. Moreover, these insights may help with public health decision-making and disease mitigation.
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Affiliation(s)
- Emily R Gordon
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Oluwaseyi Adeuyan
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Celine M Schreidah
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Caroline Chen
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Megan H Trager
- Department of Dermatology, Irving Medical Center, Columbia University, New York, NY, USA
| | - Brigit A Lapolla
- Department of Dermatology, Irving Medical Center, Columbia University, New York, NY, USA
| | - Lauren M Fahmy
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Chunhua Weng
- Department of Biomedical Informatics, Irving Medical Center, Columbia University, New York, NY, USA
| | - Larisa J Geskin
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA -
- Department of Dermatology, Irving Medical Center, Columbia University, New York, NY, USA
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Kaliampou S, Nikolaou V, Niforou A, Kotsiopoulou I, Gerochristou M, Papanikolaou A, Kanellis G, Papadavid E, Tsimpidakis A, Pouliou E, Economaki E, Panou E, Nikolaou C, Stratigos AJ, Naska A, Marinos L. Epidemiological trends in cutaneous lymphomas in Greece. Eur J Dermatol 2023; 33:664-673. [PMID: 38465548 DOI: 10.1684/ejd.2023.4617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Primary cutaneous lymphomas (PCLs) are a heterogenous group of non-Hodgkin lymphomas arising in the skin from T- or B-lymphocytes, for which there is limited epidemiological data available. To describe the disease characteristics and estimate annual incidence rates (IRs) and temporal trends of PCLs and their subtypes in Attica, Greece. A retrospective analysis of all PCL patients, diagnosed in Attica's main haemopathology referral centre from 2009 to 2021, was conducted. In total, 1,189 patients were included; 725 males and 464 females (males__females=1.56). The median age at diagnosis was 62 years. The annual IR was 2.2 new cases per 100,000 individuals. Most patients (n=979, 82.3%) were diagnosed with cutaneous T-cell lymphoma (CTCL) with a crude IR of 1.8 new cases per 100,000 person-years. Mycosis fungoides (MF) was the most common subtype (n=817, 68.7%), followed by lymphomatoid papulosis (LyP) (n=59, 5.0%). The crude IR for MF was 1.5 new cases per 100,000 person-years. Cutaneous B-cell lymphomas (CBCLs) accounted for 17.6% (n=210) of all PCLs (IR: 0.4 new cases per 100,000 person-years). PCL, CTCL and MF incidence rates increased from 2009 to 2019, followed by a decrease in 2020-2021. The incidence rate of CBCL increased steadily during the study period. The annual IRs of PCL in Greece were higher than those reported in other studies from Europe, America and Asia. The increase in IRs from 2009 to 2019 may reflect physicians' improved diagnostic efficiency. The COVID-19 pandemic may be the reason for the decline in PCL, CTCL and MF diagnoses from 2020 to 2021.
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Affiliation(s)
- Stella Kaliampou
- 1st Department of Dermatology and Venereology, Cutaneous Lymphoma Clinic, National and Kapodistrian University of Athens, "Andreas Sygros" Hospital of Venereal and Skin Diseases, Athens, Greece
| | - Vasiliki Nikolaou
- 1st Department of Dermatology and Venereology, Cutaneous Lymphoma Clinic, National and Kapodistrian University of Athens, "Andreas Sygros" Hospital of Venereal and Skin Diseases, Athens, Greece
| | - Aikaterini Niforou
- 1st Department of Dermatology and Venereology, Cutaneous Lymphoma Clinic, National and Kapodistrian University of Athens, "Andreas Sygros" Hospital of Venereal and Skin Diseases, Athens, Greece, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Kotsiopoulou
- 1st Department of Dermatology and Venereology, Cutaneous Lymphoma Clinic, National and Kapodistrian University of Athens, "Andreas Sygros" Hospital of Venereal and Skin Diseases, Athens, Greece
| | - Maria Gerochristou
- 1st Department of Dermatology and Venereology, Cutaneous Lymphoma Clinic, National and Kapodistrian University of Athens, "Andreas Sygros" Hospital of Venereal and Skin Diseases, Athens, Greece
| | | | - Georgios Kanellis
- Hematopathology Department, "Evangelismos" General Hospital, Athens, Greece
| | - Evangelia Papadavid
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece, ERNBloodNet centre for cutaneous lymphomas
| | - Antonios Tsimpidakis
- 1st Department of Dermatology and Venereology, Cutaneous Lymphoma Clinic, National and Kapodistrian University of Athens, "Andreas Sygros" Hospital of Venereal and Skin Diseases, Athens, Greece
| | - Evdoxia Pouliou
- Hematopathology Department, "Evangelismos" General Hospital, Athens, Greece
| | - Elisavet Economaki
- Hematopathology Department, "Evangelismos" General Hospital, Athens, Greece
| | - Evdoxia Panou
- 1st Department of Dermatology and Venereology, Cutaneous Lymphoma Clinic, National and Kapodistrian University of Athens, "Andreas Sygros" Hospital of Venereal and Skin Diseases, Athens, Greece
| | | | - Alexander J Stratigos
- 1st Department of Dermatology and Venereology, Cutaneous Lymphoma Clinic, National and Kapodistrian University of Athens, "Andreas Sygros" Hospital of Venereal and Skin Diseases, Athens, Greece
| | - Androniki Naska
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Leonidas Marinos
- Hematopathology Department, "Evangelismos" General Hospital, Athens, Greece
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Ashok Kumar P, Sivapiragasam A, Wang D, Huang D, Gentile T. Descriptive Analysis and Factors Influencing Survival in Patients With Primary Cutaneous Gamma-Delta T Cell Lymphoma. A Retrospective National Cancer Database Study. Clin Lymphoma Myeloma Leuk 2023; 23:897-904. [PMID: 37690902 DOI: 10.1016/j.clml.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Gamma delta T cells gives rise to a rare malignancy called Primary cutaneous Gamma-Delta T cell lymphoma (PCGDTCL). METHODS From the National Cancer Database (NCDB), 110 (0.015%) patients with PCGDTCL were identified. RESULTS Males aged >60 years were the commonest cohort. Caucasian race was the most common (Caucasian: 79.09%, African American:16.36%). Most patients were diagnosed at stage 1 (52.33%), followed by stage 4 (30.23%). On analyzing income categories, <$48,000 group had 48.15% stage 4 (13/27) and 40.74% (11/27) stage 1. Overall survival (OS) of the study group at 3 years by Kaplan-Meier (KM) analysis was 46.6%. African American race (37.5%), income of <$48,000 (27.6%) and government insurance (38.8%) had lower survival rates in KM analysis. In the adjusted hazard ratio (HR) analysis, only age <=40 years compared to >60 years (0.165 [0.036, 0.768], P= .0217) reached significance. Although the group that did not receive any chemotherapy or radiation seemed to have a better survival by KM analysis at 74.3% at 3 years, significance was not seen in the adjusted HR estimates and majority of the patients in this group were stage 1. This group may have received topical treatments which may have not been captured in NCDB. Adjusted analysis also revealed chemoradiation to have a lower mortality risk compared to chemotherapy alone (0.229 [0.079, 0.670], P = .0071), suggesting that aggressive strategies may be required for management when needed. CONCLUSION Socioeconomic disparities significantly impact access to healthcare and are of particular importance in rare lymphomas.
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Affiliation(s)
- Prashanth Ashok Kumar
- Division of Hematology-Oncology, Upstate Cancer Center, Upstate University Hospital, Syracuse, NY.
| | - Abirami Sivapiragasam
- Division of Hematology-Oncology, Upstate Cancer Center, Upstate University Hospital, Syracuse, NY
| | - Dongliang Wang
- Department of Public Health and Preventive Medicine, Upstate University Hospital, Syracuse, NY
| | - Danning Huang
- Department of Public Health and Preventive Medicine, Upstate University Hospital, Syracuse, NY
| | - Teresa Gentile
- Division of Hematology-Oncology, Upstate Cancer Center, Upstate University Hospital, Syracuse, NY
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8
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Assaf C, Dobos G, Zech IM, Doess A, May M, Jadasz J. Epidemiology of mature T/NK-cell lymphomas in Germany - A representative cross-sectional study based on SHI claims data. J Dtsch Dermatol Ges 2023; 21:1320-1327. [PMID: 37845021 DOI: 10.1111/ddg.15187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/18/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Primary cutaneous lymphomas (PCL) are rare skin tumors of lymphoproliferative neoplasms and belong to the heterogeneous group of non-Hodgkin's lymphomas. PCL encompass a broad spectrum of clinical and histologic manifestations, with cutaneous T-cell lymphoma (CTCL) being the most common (73%). Due to the rarity of the diseases, population-based studies of care and epidemiology are limited. PATIENTS AND METHODS Based on anonymized, age- and sex-adjusted SHI (statutory health insurance) claims data of approximately five million SHI-insured patients, a retrospective analysis was conducted over a six-year period (2012-2017) to determine the prevalence, incidence, and lethality in patients with mature-cell T/NK-cell lymphoma in Germany. RESULTS A total of 1,336 patients with T-cell lymphoma were identified during the observation period. The six-year prevalence ranged from 27.35 to 43.58 per 100,000. Patients were 65% male with a mean age of 66 years (SD 15). There were 246 patients (approx. 20%) who died within the 6 years, up to 7% per year. The calculated incidence in 153 identified patients in 2017 is 3.65 to 3.92 per 100,000. CONCLUSIONS For the first time, valid epidemiologic findings of patients with mature T-cell and NK-cell lymphomas were obtained using SHI claims data in Germany. Further analyses are needed to gain a deeper insight into the healthcare reality of patients with this rare disease.
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Affiliation(s)
- Chalid Assaf
- Department of Dermatology and Venerology, HELIOS Klinikum Krefeld, Krefeld, Germany
- Institute for Molecular Medicine, Hamburg Medical School, Hamburg, Germany
- Department of Dermatology, HELIOS Klinikum Schwerin, University Campus of the Hamburg Medical School, Schwerin, Germany
| | - Gabor Dobos
- Clinic for Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Joint Faculty of Medicine of Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany
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9
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McCusker S, Ngu I. Primary cutaneous lymphomas: exploration of 10-year data from supraregional mutlidisciplinary team meetings in Glasgow, UK. Clin Exp Dermatol 2023; 48:1036-1039. [PMID: 37140442 DOI: 10.1093/ced/llad169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/05/2023]
Abstract
Primary cutaneous lymphomas (PCLs) are non-Hodgkin lymphomas, presenting in the skin. They are classified into cutaneous B-cell lymphomas (CBCLs) or cutaneous T-cell lymphomas (CTCLs). The most common CTCL subtypes are mycosis fungoides (MF) and Sézary syndrome (SS). All patient's cases should be discussed at a specialist multidisciplinary team (MDT) meeting. This is the first published review, to our knowledge, of PCL MDT case discussion in the UK. Patient cases between 2008 and 2019 were reviewed to assess: frequency of PCL subtype, documentation of CTCL staging and management of MF/SS. Of 356, 103 (29%) were CBCLs and the majority (n = 200, 56%) were CTCLs. MF/SS was the diagnosis in 120 (34%). Staging was documented in 44% (n = 53) of patients with MF/SS. Management largely followed guidelines for MF/SS, topical corticosteroids were the most common treatment (n = 93, 78%). Frequency of PCL subtype is largely comparable with previously published data. Documentation of CTCL staging is low, but higher than other reports. Our work begins to address the gap in real-world data on CTCLs. A standardized approach to data collection would inform clinical practice.
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Affiliation(s)
- Sarah McCusker
- Department of Dermatology, West Glasgow Ambulatory Care Hospital, NHS Greater Glasgow & Clyde, Glasgow, UK
| | - Ivy Ngu
- Department of Dermatology, Glasgow Royal Infirmary, NHS Greater Glasgow & Clyde Glasgow, UK
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10
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Soerensen SBT, Nagy D, Ødum N, Iversen L, Lindahl LM. Chronic Obstructive Pulmonary Disease and Risk of Cutaneous T-cell Lymphoma: A Danish Population-based Cohort Study. Acta Derm Venereol 2023; 103:adv5238. [PMID: 37606154 PMCID: PMC10461176 DOI: 10.2340/actadv.v103.5238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/09/2023] [Indexed: 08/23/2023] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
| | - Dávid Nagy
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Niels Ødum
- Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Lars Iversen
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Lise M Lindahl
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
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Pileri A, Morsia E, Zengarini C, Torre E, Goteri G, Quaglino P, Pimpinelli N, Paulli M, Pileri SA, Zinzani PL, Rupoli S. Epidemiology of cutaneous T-cell lymphomas: state of the art and a focus on the Italian Marche region. Eur J Dermatol 2023; 33:360-367. [PMID: 37823487 DOI: 10.1684/ejd.2023.4531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Among primary cutaneous T-cell lymphomas (CTCL), mycosis fungoides (MF) is the most frequent and, along with Sézary syndrome (SS), the best-studied subtype. Most available studies on epidemiology of MF and SS are based on small cohorts or different inclusion criteria. Moreover, although this has become a hot topic, most studies show limitations, such as selection bias and lack of clinical information or follow-up data. Therefore, no reliable conclusions can be drawn. This paper reviews the current data underpinning our understanding of the epidemiology of MF and SS, and presents some original findings based on data retrieved from the cutaneous lymphoma registry of the Italian Marche region. The Marche Regional Cutaneous Lymphoma Registry is a multidisciplinary team founded 27 years ago to share the management of these rare disorders. All patients with a clinical and histologically confirmed diagnosis of primary cutaneous lymphoma are centralized in Ancona (Italy) at the Haematology Clinic, Polytechnic University of Marche, for clinical evaluation, staging, treatment, and follow-up. This paper emphasizes the need for a national registry of pCLs in Italy, as no detailed epidemiological information is available in the country except for the Marche Regional Cutaneous Lymphoma Registry. A national registry would allow for more comprehensive data collection from all over Italy and could provide more accurate information on incidence and epidemiology. This would be beneficial for understanding the pathogenesis and diagnostic procedures of these diseases and could improve patient outcomes. Therefore, we advise the creation of a national registry of pCLs in Italy.
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Affiliation(s)
- Alessandro Pileri
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Dermatology Unit, Italia, Department of medicine and surgery (DIMEC), University of Bologna, Bologna, Italy
| | - Erika Morsia
- AOU delle Marche, Hematology Department, Ancona, Italy, Department of Clinical and Molecular Science (DISCLIMO), Università Politecnica delle Marche, Ancona, Italy
| | - Corrado Zengarini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Dermatology Unit, Italia, Department of medicine and surgery (DIMEC), University of Bologna, Bologna, Italy
| | - Elena Torre
- AOU delle Marche, Hematology Department, Ancona, Italy
| | - Gaia Goteri
- Department of Biomedical Sciences and Public Health (DISBSP), Università Politecnica delle Marche, Ancona, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Italy
| | - Nicola Pimpinelli
- Department of Health Sciences, section Dermatology, University of Florence, Florence, Italy
| | - Marco Paulli
- Department of Molecular Medicine - Unit of Anatomic Pathology - University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Pier Luigi Zinzani
- Department of medicine and surgery (DIMEC), University of Bologna, Bologna, Italy, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Italia
| | - Serena Rupoli
- AOU delle Marche, Hematology Department, Ancona, Italy
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12
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Geskin LJ, Kwinta BD, Garcia-Saleem TJ, Akilov OE, Enz PA, Guenova E, Ortiz-Romero PL, Papadavid E, Quaglino P, Rozati S, Stonesifer CJ, Burns A, Stringer WS, Tarin E, Scarisbrick JJ. International Society for Cutaneous Lymphomas Pandemic Section (ICLYPS) analysis of cutaneous T-cell lymphoma outcomes during the COVID-19 pandemic: A retrospective cohort study. J Am Acad Dermatol 2023; 88:935-937. [PMID: 36375717 PMCID: PMC9652157 DOI: 10.1016/j.jaad.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/20/2022] [Accepted: 11/01/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Larisa J Geskin
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York.
| | - Bradley D Kwinta
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | | | - Oleg E Akilov
- Cutaneous Lymphoma Program, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Paula A Enz
- Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Emmanuella Guenova
- Department of Dermatology, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Pablo L Ortiz-Romero
- Hospital 12 de Octubre, Institute i+12, CIBERONC, Medical School, University Complutense, Madrid, Spain
| | - Evangelia Papadavid
- Attikon General University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Turin Medical School, Turin, Italy
| | - Sima Rozati
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Connor J Stonesifer
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Austin Burns
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - William S Stringer
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Eloy Tarin
- Service of Dermatology, Hospital 12 de Octubre, Institute i+12, Madrid, Spain
| | - Julia J Scarisbrick
- Department of Dermatology, University Hospital Birmingham, Birmingham, United Kingdom
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13
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Nguyen M, LeWitt T, Pang Y, Bagnowski K, Espinosa ML, Choi J, Guitart J, Liszewski W, Zhou XA. Lifestyle, demographic and Skindex measures associated with cutaneous T-cell lymphoma: a single institution cohort study. Arch Dermatol Res 2023; 315:275-278. [PMID: 35668201 PMCID: PMC10139840 DOI: 10.1007/s00403-022-02360-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/07/2022] [Accepted: 05/16/2022] [Indexed: 11/24/2022]
Abstract
Cutaneous T-cell lymphoma (CTCL) risk factors and associated quality of life are poorly understood. Previous studies of CTCL risk factors explored patient comorbidities and lifestyle exposures, but not in conjunction with disease stage, subtype, severity, or health-related quality of life (HRQoL). We investigated lifestyle exposures and demographic factors associated with advanced-stage disease, increased disease severity, and poorer HRQoL outcomes in this single-center cohort study. A cohort survey study was conducted at Northwestern's Multidisciplinary Cutaneous Lymphoma specialty clinic between April 2019 and June 2021. REDCap surveys were administered to 140 patients with CTCL, investigating patients' demographics, lifestyle and chemical exposures. QoL was evaluated using the Skindex survey; pain and itch with ten-point Likert scales. Modified Severity Weighted Assessment Tool (mSWAT), disease stage, and disease subtype were confirmed upon enrollment in the study by a single board-certified dermatologist specializing in CTCL. Factors were compared by t test or Fischer's exact test. Median age was 63 years (range 14-92) with male-to-female ratio of 1.2:1. The most common diagnosis was CD4 + MF (n = 94, 67.1%). Common lifestyle exposures included smoking (past or current) (52.3%) and chemical exposure history (all sources [53.7%]; industrial only [33.0%]). History of chemical exposures were associated with advanced stage disease (p = 0.003) and worse QoL outcomes (p = 0.001). There were significant racial differences, respectively, in early (I-IIA) vs late (IIB-IV) stage disease (p = 0.003). Obesity, hygiene, smoking, recent sun exposure, education and atopy were not significantly associated with disease stage or severity. We provide an analysis of lifestyle and demographic factors in the context of CTCL disease severity, stage, and HRQoL. We identified race as a potential risk factor for advanced stage disease and both skin phototype and chemical exposures as a risk factor for increased disease severity as measured by mSWAT. QoL outcomes were multifactorial and significantly associated with history of chemical exposure, severe pain/itch, race, disease stage and subtype. An improved understanding of these associations may lead to better individualized care. As chemical exposure and race were found to be significant factors associated with advanced-stage disease, taking exposure histories and addressing racial disparities may improve care for CTCL patients.
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Affiliation(s)
- Morgan Nguyen
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tessa LeWitt
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Yanzhen Pang
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katherine Bagnowski
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Maria L Espinosa
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jaehyuk Choi
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joan Guitart
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Walter Liszewski
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Xiaolong Alan Zhou
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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14
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Falkenhain-López D, Muniesa C, Estrach MT, Morillo-Andújar M, Peñate Y, Acebo E, Pujol RM, García-Muret MP, Machan S, Medina S, Botella-Estrada R, Fernández de Misa R, Blanes M, Flórez A, Pérez-Paredes G, Izu R, Yanguas I, Silva-Díaz E, Pérez-Ferriols A, Prieto-Torres L, Zayas A, Parera-Amer ME, Pérez A, Aspe L, Román C, Sánchez-Caminero MP, Bassas-Vila J, Domínguez-Auñón JD, Calzado L, Navedo M, Ortiz-Prieto A, Servitje O, Polo-Rodríguez I, Torres I, Hernández-Hernández MN, Mitxelena-Eceiza J, García-Vázquez A, García-Doval I, Ortiz-Romero PL. [Translated article] Primary Cutaneous Lymphoma Registry of the Spanish Academy of Dermatology and Venereology (AEDV): Data for the First 5 Years. Actas Dermosifiliogr 2023; 114:T291-T298. [PMID: 36848951 DOI: 10.1016/j.ad.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/12/2022] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Primary cutaneous lymphomas (PCL) are uncommon. Observations based on the first year of data from the Spanish Registry of Primary Cutaneous Lymphomas (RELCP, in its Spanish abbreviation) of the Spanish Academy of Dermatology and Venereology (AEDV) were published in February 2018. This report covers RELCP data for the first 5 years. PATIENTS AND METHODS RELCP data were collected prospectively and included diagnosis, treatments, tests, and the current status of patients. We compiled descriptive statistics of the data registered during the first 5 years. RESULTS Information on 2020 patients treated at 33 Spanish hospitals had been included in the RELCP by December 2021. Fifty-nine percent of the patients were men; the mean age was 62.2 years. The lymphomas were grouped into 4 large diagnostic categories: mycosis fungoides/Sézary syndrome, 1112 patients (55%); primary B-cell cutaneous lymphoma, 547 patients (27.1%); primary CD30+ lymphoproliferative disorders, 222 patients (11%), and other T-cell lymphomas, 116 patients (5.8%). Nearly 75% of the tumors were registered in stage I. After treatment, 43.5% achieved complete remission and 27% were stable at the time of writing. Treatments prescribed were topical corticosteroids (1369 [67.8%]), phototherapy (890 patients [44.1%]), surgery (412 patients [20.4%]), and radiotherapy (384 patients [19%]). CONCLUSION The characteristics of cutaneous lymphomas in Spain are similar to those reported for other series. The large size of the RELCP registry at 5 years has allowed us to give more precise descriptive statistics than in the first year. This registry facilitates the clinical research of the AEDV's lymphoma interest group, which has already published articles based on the RELCP data.
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Affiliation(s)
- D Falkenhain-López
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - C Muniesa
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M T Estrach
- Departamento de Dermatología, Hospital Clínico, IDIBAPS, Universitario de Barcelona, Barcelona, Spain
| | - M Morillo-Andújar
- Departamento de Dermatología, Hospital Virgen del Rocío, Sevilla, Spain
| | - Y Peñate
- Departamento de Dermatología, Complejo Hospitalario Universitario Insular Materno-Infantil, Gran Canaria, Spain
| | - E Acebo
- Departamento de Dermatología, Hospital Universitario de Cruces, Barakaldo, Bizkaia, Spain
| | - R M Pujol
- Departamento de Dermatología, Hospital del Mar, Barcelona, Spain
| | - M P García-Muret
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, UAB Barcelona, Barcelona, Spain
| | - S Machan
- Departamento de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - S Medina
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - R Botella-Estrada
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, Spain
| | - R Fernández de Misa
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain
| | - M Blanes
- Departamento de Dermatología, Hospital General Universitario de Alicante, Alicante, Spain
| | - A Flórez
- Departamento de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - G Pérez-Paredes
- Departamento de Dermatología, Hospital Universitario Marqués de Valdecilla, Santander Cantabria, Spain
| | - R Izu
- Departamento de Dermatología, Hospital Universitario de Basurto, Bilbao, Bizkaia, Spain
| | - I Yanguas
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, Spain
| | - E Silva-Díaz
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - A Pérez-Ferriols
- Departamento de Dermatología, Hospital General Universitario de Valencia, Valencia, Spain
| | - L Prieto-Torres
- Departamento de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - A Zayas
- Departamento de Dermatología, Hospital Universitario Dr. Peset, Valencia, Spain
| | - M E Parera-Amer
- Departamento de Dermatología, Hospital Universitario Son Llàtzer, Palma, Islas Baleares, Spain
| | - A Pérez
- Departamento de Dermatología, Hospital Universitario Nuestra Señora De Valme, Sevilla, Spain
| | - L Aspe
- Departamento de Dermatología, Hospital Universitario de Araba, Vitoria-Gasteiz, Álava, Spain
| | - C Román
- Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - M P Sánchez-Caminero
- Departamento de Dermatología, Hospital General de Ciudad Real, Ciudad Real, Spain
| | - J Bassas-Vila
- Departamento de Dermatología, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - J D Domínguez-Auñón
- Departamento de Dermatología, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - L Calzado
- Departamento de Dermatología, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
| | - M Navedo
- Departamento de Dermatología, Complejo Asistencial Universitario de León, León, Spain
| | - A Ortiz-Prieto
- Departamento de Dermatología, Hospital Puerta del Mar, Cádiz, Spain
| | - O Servitje
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - I Polo-Rodríguez
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - I Torres
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, Spain
| | - M N Hernández-Hernández
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain
| | - J Mitxelena-Eceiza
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, Spain
| | - A García-Vázquez
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, León, Spain; Departamento de Dermatología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | - P L Ortiz-Romero
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain
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Hooper MJ, Veon FL, Enriquez GL, Nguyen M, Grimes CB, LeWitt TM, Pang Y, Case S, Choi J, Guitart J, Burns MB, Zhou XA. Retrospective analysis of sepsis in cutaneous T-cell lymphoma reveals significantly greater risk in Black patients. J Am Acad Dermatol 2023; 88:329-337. [PMID: 36265823 PMCID: PMC9839541 DOI: 10.1016/j.jaad.2022.10.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 09/17/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sepsis is a leading cause of morbidity, mortality, and resource utilization among patients with cutaneous T-cell lymphoma (CTCL). OBJECTIVE To characterize the demographic, clinical, and microbial attributes distinguishing patients with CTCL sepsis from other patients with non-Hodgkin lymphoma (NHL) sepsis and patients with CTCL in general. METHODS Two-part retrospective cohort study at an academic medical center from 2001-2019 involving patients with CTCL (n = 97) and non-CTCL NHL (n = 88) admitted with sepsis, and a same-institution CTCL patient database (n = 1094). Overall survival was estimated by Kaplan-Meier analyses. RESULTS Patients with CTCL sepsis were more likely to be older, Black, experience more sepsis episodes, die or be readmitted within 30 days of an inpatient sepsis episode, and develop Gram-positive bacteremia than patients with non-CTCL NHL sepsis. Staphylococcus aureus and Escherichia coli were the most frequently speciated organisms in CTCL (26%) and non-CTCL NHL (14%), respectively. No between-group differences were identified regarding sex, presence of central line, chemotherapy use, or disease stage. Compared with general patients with CTCL, patients with sepsis were Black and exhibited advanced-stage disease, higher body surface area involvement, and higher lactate dehydrogenase levels. LIMITATIONS Single institution, retrospective nature may limit generalizability. CONCLUSION Awareness of CTCL-specific risk factors is crucial for guiding sepsis prevention and improving patient outcomes.
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Affiliation(s)
- Madeline J Hooper
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Francesca L Veon
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Gail L Enriquez
- Department of Biology, Loyola University Chicago, Chicago, Illinois
| | - Morgan Nguyen
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Cameron B Grimes
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Tessa M LeWitt
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Yanzhen Pang
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Slaton Case
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jaehyuk Choi
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Joan Guitart
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Michael B Burns
- Department of Biology, Loyola University Chicago, Chicago, Illinois
| | - Xiaolong A Zhou
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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16
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Glinos G, Wei G, Nosewicz J, Abdulla F, Chen PL, Chung C, Kaffenberger BH, Querfeld C, Shinohara MM, Sokol L, Zain J, Kumar A, Seminario-Vidal L. Characteristics and Outcomes for Hospitalized Patients With Cutaneous T-Cell Lymphoma. JAMA Dermatol 2023; 159:192-197. [PMID: 36598766 PMCID: PMC9857769 DOI: 10.1001/jamadermatol.2022.5740] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 11/03/2022] [Indexed: 01/05/2023]
Abstract
Importance Cutaneous T-cell lymphoma (CTCL) is a group of rare, complex cutaneous malignant neoplasms associated with significant disease burden on patients and the health care system. Currently, the population of patients with CTCL admitted to the hospital remains largely uncharacterized and poorly understood. Objective To characterize the clinical characteristics, course of hospitalization, and mortality outcomes of an inpatient CTCL cohort. Design, Setting, and Participants This multicenter retrospective cohort study reviewed medical records for adult patients (age ≥18 years) with a CTCL diagnosis per National Comprehensive Cancer Network guidelines admitted for inpatient hospitalization at 5 US academic medical centers with inpatient dermatology consult services and CTCL clinics between August 2016 and August 2020. Main Outcomes and Measures Patient demographics, clinical history and findings, hospitalization courses, and mortality outcomes. Results A total of 79 hospitalized patients with CTCL were identified, including 52 (70.3%) men and 22 (29.7%) women, with a median (IQR) age at hospitalization of 62.9 (27-92) years. The majority of admitted patients with CTCL were White (65 patients [82.3%]), had disease classified as mycosis fungoides (48 patients [61.5%]), and had advanced-stage disease (≥IIB, 70 patients [89.7%]). Most hospitalizations were complicated by infection (45 patients [57.0%]) and required intravenous antibiotic therapy (45 patients [57.0%]). In-hospital mortality occurred in 6 patients (7.6%) and was associated with higher body mass index (36.5 vs 25.3), history of thromboembolic disease (50.0% vs 12.3%), and diagnosis of sepsis on admission (66.7% vs 20.5%). At 1-year postdischarge, 36 patients (49.3%) patients had died, and mortality was associated with history of solid organ cancers (27.8% vs 10.8%), wound care as the reason for dermatology consultation (58.3% vs 24.3%), and presence of large cell transformation (58.3% vs 22.9%). Conclusions and Relevance The findings of this cohort study improve the understanding of hospitalized patients with CTCL and lend valuable insight into identifying factors associated with both in-hospital and long-term mortality outcomes. This refined understanding of the inpatient CTCL population provides a foundation for larger, more robust studies to identify causal risk factors associated with mortality, development of prognostic scoring systems to estimate the probability of hospital mortality. Overall, the findings may prompt physicians caring for patients with CTCL to implement preventive strategies to diminish hospitalization and improve clinical management across this unique disease spectrum.
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Affiliation(s)
- George Glinos
- Department of Dermatology and Cutaneous Surgery, USF Health Morsani College of Medicine, Tampa, Florida
| | - Grace Wei
- Department of Dermatology and Cutaneous Surgery, USF Health Morsani College of Medicine, Tampa, Florida
| | - Jacob Nosewicz
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus
| | - Farah Abdulla
- Division of Dermatology, Department of Pathology, City of Hope National Medical Center and Beckman Research Institute, Duarte, California
| | - Pei-Ling Chen
- Cutaneous Oncology Program, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Catherine Chung
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus
| | | | - Christiane Querfeld
- Division of Dermatology, Department of Pathology, City of Hope National Medical Center and Beckman Research Institute, Duarte, California
| | - Michi M. Shinohara
- Division of Dermatology, Department of Medicine, University of Washington, Seattle
| | - Lubomir Sokol
- Malignant Hematology Program, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Jasmine Zain
- Division of Dermatology, Department of Pathology, City of Hope National Medical Center and Beckman Research Institute, Duarte, California
| | - Ambuj Kumar
- Center for Evidence-Based Medicine and Health Outcomes Research, University of South Florida, Tampa
| | - Lucia Seminario-Vidal
- Department of Dermatology and Cutaneous Surgery, USF Health Morsani College of Medicine, Tampa, Florida
- Cutaneous Oncology Program, H. Lee Moffitt Cancer Center, Tampa, Florida
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17
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Abstract
AIM Cutaneous T-cell Lymphoma (CTCL) is a rare form of non-Hodgkin lymphoma characterized by skin lesions, which can negatively impact the quality of life of both patients and their caregivers. The Decision Support Unit (DSU) at the National Institute for Health and Care Excellence (NICE) in the UK recently outlined a rationale for the inclusion of caregiver burden in economic evaluations. This study aimed to estimate utilities for health states associated with being a caregiver for an individual with CTCL at different stages of treatment. MATERIALS AND METHODS A targeted literature review and interviews with CTCL specialists informed the development of health state vignettes describing the experience caring for an individual with CTCL. The vignettes were evaluated in interviews with the UK general population using a visual analogue scale (VAS), the time trade-off (TTO) method and the EQ-5D-5L. RESULTS Four vignettes were developed describing the caregiver experience for an individual with CTCL on i) second line treatment, ii) third line treatment, iii) end of life care, iv) a post-patient death. One hundred interviews were conducted to evaluate the health state vignettes. The pattern of results was similar across the evaluation methods: second line treatment (VAS: 39.2, TTO = 0.52, EQ-5D-5L: 0.56), third line treatment (VAS: 31.1, TTO = 0.39, EQ-5D-5L: 0.37), end of life care (VAS: 28.2, TTO = 0.37, EQ-5D-5L: 0.31) and post-patient death (VAS: 41.2, TTO = 0.63, EQ-5D-5L: 0.59). Limitations and conclusions: These findings highlight the substantial burden of caring for an individual with CTCL and the importance of including caregiver burden in the health technology assessment review process. A limitation is the hypothetical vignette approach, which meant the TTO participants did not have experience of caring for individuals with CTCL, but were imagining this state. There is also the possibility that they may also be considering the patient experience when responding to the questions.
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18
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Semenov YR, Rosenberg AR, Herbosa C, Mehta-Shah N, Musiek AC. Health-related quality of life and economic implications of cutaneous T-cell lymphoma. Br J Dermatol 2020; 182:190-196. [PMID: 30920642 PMCID: PMC7024588 DOI: 10.1111/bjd.17941] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Cutaneous T-cell lymphoma (CTCL) has been associated with considerable physical, psychological and financial burden. However, its impact on health-related quality of life (QoL) and economic costs are not well studied. OBJECTIVES To measure the QoL impact and financial burden of CTCL. METHODS A cross-sectional survey of 67 patients with CTCL was conducted using the Ontario Health Utilities Index Mark 3 (HUI3) questionnaire. Normative population data (n = 3310) were obtained from the 2002-2003 Joint Canada/United States Survey of Health. Economic cost was estimated using quality-adjusted life-year (QALY) loss derived from HUI3 scores. RESULTS Patients with CTCL had significantly lower aggregate HUI3 scores than the general population (0·68 vs. 0·87, P < 0·001). Multivariable regression analysis adjusting for demographics and comorbidities showed CTCL was associated with significantly poorer performance overall (-0·13, 95% CI -0·21 to -0·06, P < 0·001) and in domains of speech (-0·03, 95% CI -0·05 to -0·01, P = 0·01), ambulation (-0·04, 95% CI -0·08 to 0·00, P = 0·03), emotion (-0·07, 95% CI -0·12 to -0·02, P = 0·01), and pain (-0·07, 95% CI -0·13 to -0·01, P = 0·03). These health utility decrements yielded an average loss of 1·48 QALYs per patient. Using a $50 000 per QALY willingness-to-pay threshold, CTCL was associated with an individual lifetime burden of $73 889 and U.S. societal burden of $2·86 billion. CONCLUSIONS These findings suggest CTCL has a pervasive impact on QoL, comparable with debilitating conditions such as end-stage renal disease. The substantial economic burden of CTCL underscores the potential societal benefit of prompt diagnosis and effective management. What's already known about this topic? Cutaneous T-cell lymphoma is associated with physical, psychological and financial burden. What does this study add? The overall quality-of-life impact of cutaneous T-cell lymphoma has not previously been measured using a generic health utility instrument. In this study, we compare the overall quality-of-life burden of patients with cutaneous T-cell lymphoma with that of other populations and calculate the economic burden of the disease.
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Affiliation(s)
- Y R Semenov
- Washington University School of Medicine, Division of Dermatology, St. Louis, MO, U.S.A
| | - A R Rosenberg
- Washington University School of Medicine, Division of Dermatology, St. Louis, MO, U.S.A
| | - C Herbosa
- Washington University School of Medicine, Division of Dermatology, St. Louis, MO, U.S.A
| | - N Mehta-Shah
- Washington University School of Medicine, Siteman Cancer Center, St. Louis, MO, U.S.A
| | - A C Musiek
- Washington University School of Medicine, Division of Dermatology, St. Louis, MO, U.S.A
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19
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Ramachandran V, Park KE, Shah JR, Duvic M. Diagnosis of cutaneous T-cell lymphoma by insurance type before and after the Affordable Care Act: a national database study. Dermatol Online J 2019; 25:13030/qt5n4481mk. [PMID: 32045145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023] Open
Abstract
The Affordable Care Act (ACT) was implemented to increase health care access and reduce the uninsured in the age group between pediatric and Medicare populations (18-64). The association of the ACA with insurance type upon diagnosis (uninsured, Medicaid, non-Medicaid) has been investigated for otolaryngologic, gynecologic, and the top five non-skin malignancies. Such studies for cutaneous malignancies are lacking. We conducted a retrospective analysis of the prospective National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) cancer database to assess the impact of the ACA on new diagnoses of cutaneous T-cell lymphoma (CTCL) by insurance type. Unlike prior studies of other malignancies, we did not observe significant differences between rate of diagnosis of CTCL by insurance type before and after full implementation of the ACA in all states, expansion states, and non-expansion states. Skin cancers do not have screening guidelines and CTCL is an uncommon malignancy, both of which may contribute to these findings. However, Medicaid-expansion states were much closer to reducing the percentage of newly diagnosed uninsured patients with CTCL than non-expansion states. As such, it may be prudent to investigate intrinsic socioeconomic barriers to care in Medicaid patients to improve their access to care to decrease the uninsured population and improve outcomes.
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Affiliation(s)
- Vignesh Ramachandran
- Baylor College of Medicine, Houston, Texas, USA The University of Texas MD Anderson Cancer Center, Houston, TX.
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20
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Abstract
BACKGROUND In addition to a broad and clinically diverse spectrum of known primary cutaneous lymphomas, for which an incidence of 1-3:100,000 is postulated, each year further entities are specified and defined. The goal is the presentation of a case series from daily clinical routine. METHODS Over a period of 6 years and 2 months, patients consulting the Department of Dermatology, Medical Center University of Freiburg, were registered. Subsequently, collectives of mycosis fungoides (MF), Sezary syndrome (SS), CD30+ lymphoproliferative diseases, single cases with rare primary cutaneous lymphomas, and subcollectives of B‑cell lymphomas were examined. The high number of MF cases allowed the additional quantitative analyses of the types of therapies used in this group. RESULTS Yearly 16-25 new diagnoses of primary cutaneous lymphoma are made. The evaluation of 163 primary cutaneous lymphoma revealed 111 cases with MF (68.1%), including 9 particular variants, 15 primary cutaneous CD30+ lymphoproliferative diseases (9.2%) dominated by 10 lymphomatoid papulosis (LyP), in addition to 5 primary cutaneous anaplastic large cell lymphoma (PCALCL), 6 SS (3.68%), and 24 cutaneous B‑cell lymphomas (14-72%). Three cases with rare primary cutaneous T/NK cell lymphomas are addressed in detail. In all, 82% of MF cases were stage IA and IB. The descending use of therapies for stage I-III included steroids and diverse UV therapies followed by bexarotene, interferon-α, methotrexate, and extracorporal photophoresis. CONCLUSIONS Diagnoses of cutaneous lymphomas belong to a vast spectrum of differential diagnoses. This registry describes frequent findings and shows rare variants. You can only diagnose what you know; accordingly, a collection of case reports, which we wish to encourage, can help in processing and specification of entities.
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Affiliation(s)
- D Nashan
- Hautklinik, Klinikum Dortmund gGmbH, Beurhausstr. 40, 44137, Dortmund, Deutschland.
| | - C M Friedrich
- Fachhochschule Dortmund - Fachbereich Informatik und Institut für Medizinische Informatik, Biometrie und Epidemiologie (IMIBE), Universitätsklinikum Essen, Essen, Deutschland
| | - E Geissler
- Hautklinik, Klinikum Ludwigshafen, Ludwighafen, Deutschland
| | - A Schmitt-Graeff
- Institut für Klinische Pathologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
- Medizinische Fakultät, Albert-Ludwigs-Universität, Freiburg, Deutschland
| | - F Klein
- Wissenschaftliche Fachkommunikation, München, Deutschland
| | - F Meiss
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
- Medizinische Fakultät, Albert-Ludwigs-Universität, Freiburg, Deutschland
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21
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Willemze R, Hodak E, Zinzani PL, Specht L, Ladetto M. Primary cutaneous lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018; 29:iv30-iv40. [PMID: 29878045 DOI: 10.1093/annonc/mdy133] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
MESH Headings
- Administration, Cutaneous
- Aftercare/methods
- Aftercare/standards
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/standards
- Biomarkers, Tumor/genetics
- CD79 Antigens/genetics
- Chemoradiotherapy/methods
- Dermatologic Surgical Procedures/methods
- Dermatologic Surgical Procedures/standards
- Europe
- Humans
- Incidence
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/epidemiology
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/pathology
- Lymphoma, T-Cell, Cutaneous/therapy
- Medical Oncology/methods
- Medical Oncology/standards
- Myeloid Differentiation Factor 88/genetics
- Neoplasm Staging
- Ointments
- Precision Medicine/methods
- Precision Medicine/standards
- Skin/drug effects
- Skin/pathology
- Skin Neoplasms/diagnosis
- Skin Neoplasms/epidemiology
- Skin Neoplasms/pathology
- Skin Neoplasms/therapy
- Societies, Medical/standards
- Survivorship
- Treatment Outcome
- Ultraviolet Therapy/methods
- Ultraviolet Therapy/standards
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Affiliation(s)
- R Willemze
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - E Hodak
- Department of Dermatology, Rabin Medical Centre, Beilinson Hospital, Petach Tikva, Israel
| | - P L Zinzani
- Institute of Hematology and Medical Oncology, University of Bologna, Bologna, Italy
| | - L Specht
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - M Ladetto
- Divisione di Ematologia, Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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22
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Abstract
Cutaneous T-cell lymphomas (CTCL), especially mycosis fungoides, can be considered as a state of longstanding low-grade systemic inflammation. Many studies have focused on secondary cancers with CTCL, but information about comorbidities is limited. A total of 144 patients with CTCL at Helsinki University Central Hospital during 2005 to 2015 were studied to determine associated comorbidities and causes of death in this cohort. Compared with an age-standardized control population, the prevalence of type 2 diabetes mellitus was increased among patients with CTCL with no link to obesity. Patients with CTCL had a lower prevalence of hypertension, myocardial infarction and stroke than the control group. The 3 most common causes of death were CTCL, coronary artery disease and lung cancer. The increased risk of myocardial infarction or stroke reported previously was not detected in this patient group.
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Affiliation(s)
- Liisa Väkevä
- Department of Dermatology, Center of Inflammation, Skin and Allergy Hospital, FIN-00250 Helsinki, Finland.
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23
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Lee WJ, Lee SH, Moon IJ, Won CH, Chang SE, Choi JH, Park CS, Suh C, Lee MW. Relative Frequency, Clinical Features, and Survival Outcomes of 395 Patients with Cutaneous Lymphoma in Korea: A Subgroup Analysis per 10-year Period. Acta Derm Venereol 2016; 96:888-893. [PMID: 26975334 DOI: 10.2340/00015555-2404] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Long-term changes in the relative frequency of cutaneous lymphoma (CL) have not been investigated in Asian populations. The aim of this study was to investigate the relative frequency, clinical characteristics, and survival outcomes of CL in Korean patients, and to evaluate the changes in relative frequency of CL over a 20-year period. The present retrospective cohort study included 395 patients, of whom 289 had primary CL and 106 secondary CL, seen at a tertiary referral hospital in Seoul, Korea. Primary CL included T-/NK-cell linage lymphoma (CTCL, 85.1%) and B-cell lineage lymphoma (CBCL, 14.9%). The relative frequency of CBCL increased over time, as shown by a decrease in the CTCL/CBCL ratio from 10.3 in 1994 to 2003 to 4.5 in 2004 to 2013. CTCL was more commonly associated with multiple and extensive skin lesions than CBCL. Extranodal NK/T-cell lymphoma and subcutaneous panniculitis-like T-cell lymphoma were commonly associated with extensive skin lesions. The 5-year overall survival rate for all patients with primary CL was 81%.
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Affiliation(s)
- Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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24
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Cieza-Díaz DE, Conde-Montero E, Menarguez-Palanca J, Longo-Imedio I. Epidemiological and clinical features of patients diagnosed with cutaneous T-cell lymphomas in a Spanish tertiary care hospital. J Eur Acad Dermatol Venereol 2016; 31:e150-e153. [PMID: 27518589 DOI: 10.1111/jdv.13914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- D E Cieza-Díaz
- Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - E Conde-Montero
- Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J Menarguez-Palanca
- Department of Pathology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - I Longo-Imedio
- Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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25
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Lee HS, Suh KS, Lee DY, Cho KH, Oh SH, Kim SC, Lee SJ, Shin DH, Yoon TY, Won YH, Kim YC. Cutaneous Lymphoma in Korea: A Nationwide Retrospective Study. Acta Derm Venereol 2016; 96:535-9. [PMID: 26560051 DOI: 10.2340/00015555-2283] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The epidemiological and clinicopathological features of cutaneous lymphoma may vary by geographical area. However, only a few large-scale epidemiological studies of cutaneous lymphoma have been performed, mainly in the USA and Europe. This aim of this study was to determine the recent characteristics of cutaneous lymphoma in Korea according to the WHO/EORTC classification. A total of 422 patients with newly diagnosed cutaneous lymphoma from January 2009 to December 2013 comprising 293 cases of mature T-cell and natural killer (NK)-cell lymphoma and 39 cases of mature B-cell lymphoma were retrospectively reviewed. The incidence of mature B-cell lymphoma was lower in Korea than in Europe and the USA. Diffuse large B-cell lymphoma was more prevalent in Korea than in Western countries. The incidence of extranodal NK/T-cell lymphoma, nasal-type was higher in Korea than in Western countries and Japan.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Child
- Child, Preschool
- Female
- Humans
- Incidence
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/epidemiology
- Lymphoma, B-Cell/therapy
- Lymphoma, Extranodal NK-T-Cell/diagnosis
- Lymphoma, Extranodal NK-T-Cell/epidemiology
- Lymphoma, Extranodal NK-T-Cell/therapy
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/therapy
- Male
- Middle Aged
- Prevalence
- Prognosis
- Republic of Korea/epidemiology
- Retrospective Studies
- Skin Neoplasms/diagnosis
- Skin Neoplasms/epidemiology
- Skin Neoplasms/therapy
- Time Factors
- Young Adult
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Affiliation(s)
- Hyun Soo Lee
- Department of Dermatology, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, 443-380, Korea
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26
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Amber KT, Bloom R, Nouri K. Second Primary Malignancies in CTCL Patients from 1992 to 2011: A SEER-Based, Population-Based Study Evaluating Time from CTCL Diagnosis, Age, Sex, Stage, and CD30+ Subtype. Am J Clin Dermatol 2016; 17:71-7. [PMID: 26386881 DOI: 10.1007/s40257-015-0155-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cutaneous T-cell lymphoma (CTCL) is a diverse group of extranodal non-Hodgkin lymphomas with malignant T lymphocytes localizing in the skin. CTCL can mainly be classified as mycosis fungoides, Sézary syndrome, or primary cutaneous CD30+ lymphoma. Patients with CTCL have an increased risk of developing second primary malignancies. OBJECTIVE Our objective was to analyze the overall incidence of second primary malignancies in patients with CTCL by age, sex, stage, and the primary cutaneous CD30+ lymphoproliferative subtype of CTCL, as this group has usually been excluded from previous analyses. METHODS We used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate CTCL cases diagnosed between 1992 and 2011. We calculated the multiple primary standardized incidence ratio, comparing the observed incidence of second primary malignant neoplasms in the CTCL patient population versus the general population. RESULTS CTCL is associated with an overall increased risk of cancers. This incidence is greatest within the first year of diagnosis. The risk of secondary Hodgkin disease is greatest in patients aged ≥60 years; the risk of secondary non-Hodgkin lymphoma is greatest in patients aged 20-39. Males demonstrated a significantly increased risk of developing Hodgkin lymphoma, while females showed a significantly increased risk of developing bronchopulmonary malignancy. Overall, secondary malignancy incidence was significantly elevated for stage I and IV CTCL. Patients with CD30+ CTCL had a significantly higher incidence of Hodgkin lymphoma, non-Hodgkin lymphoma, and urinary cancers than the general population. CONCLUSION Occult secondary malignancies, particularly lymphomas, should be considered in adult CTCL patients, including those with the CD30+ subtype.
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MESH Headings
- Adolescent
- Adult
- Age Factors
- Child
- Child, Preschool
- Female
- Humans
- Incidence
- Infant
- Infant, Newborn
- Ki-1 Antigen/analysis
- Lymphoma, T-Cell, Cutaneous/classification
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/pathology
- Male
- Middle Aged
- Neoplasm Staging
- Neoplasms, Second Primary/classification
- Neoplasms, Second Primary/epidemiology
- Neoplasms, Second Primary/pathology
- Risk
- SEER Program
- Sex Factors
- Skin Neoplasms/classification
- Skin Neoplasms/epidemiology
- Skin Neoplasms/pathology
- Time Factors
- Young Adult
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Affiliation(s)
- Kyle T Amber
- Department of Dermatology, University of California Irvine Medical Center, Irvine, CA, USA.
| | - Romi Bloom
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, 10660 SW 75th Ave., Miami, FL, 33156, USA
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, 10660 SW 75th Ave., Miami, FL, 33156, USA
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27
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Moreau JF, Buchanich JM, Geskin JZ, Akilov OE, Geskin LJ. Non-random geographic distribution of patients with cutaneous T-cell lymphoma in the Greater Pittsburgh Area. Dermatol Online J 2014; 20:13030/qt4nw7592w. [PMID: 25046454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 07/15/2014] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Environmental hazards may play a role in the etiology of cutaneous T-cell lymphoma (CTCL). Some studies have found an increased incidence of CTCL among workers in chemical science, transportation, and manufacturing industries, but other studies have not. This discrepancy may be attributable to population migration, complicating accurate assessment of lifetime exposures. The Pittsburgh population has very low migration rates and most CTCL patients seen at the University of Pittsburgh Medical Center (UPMC) Cutaneous Lymphoma Center are life-long local residents. The Greater Pittsburgh Area used to be an industrial hub. There are residential communities positioned within close proximity to inactive industrial sites that continue to contain pollutants. OBJECTIVE To determine whether CTCL patients' residences cluster within specific Pittsburgh regions, in particular, those with high levels of environmental pollutants. METHODS Our study included patients diagnosed with CTCL at the UPMC Cutaneous Lymphoma Center between 2000 and 2012. We mapped the longitudinal and latitudinal coordinates of patients' residences at diagnosis, superfund sites, toxic release inventory sites, particular matter levels, and dermatologists' offices using ArcMap 10.1. We then performed a SaTScan analysis using zip codes to assess for geographic clustering of patients' residences in the Pittsburgh metropolitan statistical area. We assessed for a correlation between case distribution and both environmental hazards sites and dermatologist density in the area. RESULTS We identified 274 patients with CTCL in the Greater Pittsburgh area. We identified a statistically significant geographic cluster (p<.001) in zip code 15213, which is the most densely populated neighborhood in Pittsburgh and the site of the region's only CTCL clinic. We observed no relationship between the locations of superfund sites, toxic release inventory sites, or particular matter levels and CTCL case distribution. CONCLUSION Our findings do not support an association between exposure to environmental toxins and CTCL. CTCL cases clustered in areas with the highest population density, which also happen to include a regional CTCL center. To evaluate a possibility of urban pollutants playing a role in etiology of CTCL, dermatologist density and access to care need to be addressed as potential confounders in the future studies.
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28
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Tomasini D, Berti E. Subcutaneous panniculitis-like T-cell lymphoma. GIORN ITAL DERMAT V 2013; 148:395-411. [PMID: 23900161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Subcutaneous panniculitis like T-cell lymphoma derived from α/β T-cells (SPTCL-AB) belongs to the group of primary cutaneous T-cell lymphoma, and it represents less than the 1% of all primary cutaneous T-cell lymphomas. It affects patients in the 4th decade of life (median age of 36 years) with a female preference (male/female ratio 0.5) with 19% of patients being 20 years or younger. It can be sometime complicated by a hemophagocytic syndrome, and patients without hemophagocytic syndrome had a significantly better survival (5-year OS: 91% vs. 46%). Histopathologically, SPTCL-AB is characterized by a lobular lymphocytic panniculitis. Tumor cells distribute between individual adipose lobules, proliferating and forming "rim" and "capping" images, conferring a lace-like appearance at scanning magnification. This is not an entirely disease-specific feature, and can also be seen in other lobular lymphocytic panniculitis, either of inflammatory and neoplastic origin. Tumor cells are phenotypically CD45RO+, βF1+ (a monoclonal antibody able to identify the alpha/beta chain of TCR), CD3+, CD4-, CD8+, and express cytotoxic granules (TIA-1, granzyme and perforin), whereas they show variable deletion of T-cell restricted antigens like CD2, CD5 and CD7. The majority of cases show a monoclonal rearrangement for TCR beta and gamma genes and do not show genomic integration of EBV. The present review will focus on histopathologic, immunophenotypical and molecolare data useful to overcome to a specific diagnosis of SPTCL-AB and to differentiate SPTCL-AB from other lymphomas of T-cell or NK/T cell origin and with benign panniculitidis sharing with SPTCL-AB a predominant lobular lymphocytic pattern of involvement of subcutaneous tissue.
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MESH Headings
- Adult
- Age Distribution
- Antigens, CD/analysis
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Dermis/pathology
- Diagnosis, Differential
- Female
- Gene Rearrangement, beta-Chain T-Cell Antigen Receptor
- Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor
- Humans
- Immunophenotyping
- Immunosuppressive Agents/therapeutic use
- Lymphohistiocytosis, Hemophagocytic/etiology
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/drug therapy
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/pathology
- Male
- Neoplasm Staging
- Panniculitis/classification
- Panniculitis/diagnosis
- Prognosis
- Sex Distribution
- Subcutaneous Tissue/pathology
- T-Lymphocytes, Cytotoxic/pathology
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Affiliation(s)
- D Tomasini
- Dermatology Section, Busto Arsizio Hospital Busto Arsizio, Varese, Italy -
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29
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Grassi S, Borroni RG, Brazzelli V. Panniculitis in children. GIORN ITAL DERMAT V 2013; 148:371-385. [PMID: 23900159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This paper will give a comprehensive view of the most frequent panniculitides seen in childhood, with emphasis on the types exclusively found in infancy, and for all other types of panniculitides also found in adults. Aim of this paper is also to analyze the clinical differences between panniculitis in childhood and in adulthood, and to give reliable histopathologic criteria for a specific diagnosis. A review of the literature is here integrated by authors' personal contribution. Panniculitides in children is a heterogeneous group of diseases, as well as in adult life, characterized by inflammation of the subcutaneous fat. Only very few types of panniculitis are exclusively found in childhood, such as Sclerema neonatorum and subcutaneous fat necrosis of the newborn, while the vast majority of the other types may be found both in paediatric age and in adults. Furthermore, this paper will consider in detail panniculitis according to their frequency, such as Erythema nodosum, Lupus panniculitis, Cold panniculitis, panniculitis in Behçet disease, and poststeroid panniculitis. It will also describe rare forms of panniculitis, such as Eosinophilic panniculitis (a pathological entity debated by many authors), Subcutaneous panniculitis T-cell lymphoma, and the different forms of the so call "Lipophagic panniculitis", encompassing respectively the febrile relapsing panniculitis of Weber-Christian disease and the non-relapsing form of Rothmann-Makai disease. For each type of panniculitis considered concise information will be given about epidemiology, etiology, clinical findings, laboratory data, prognosis and therapy, while histopathologic findings will be described in detail.
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MESH Headings
- Adrenal Cortex Hormones/adverse effects
- Age of Onset
- Behcet Syndrome/complications
- Cellulitis/blood
- Cellulitis/epidemiology
- Cellulitis/pathology
- Cellulitis/therapy
- Child
- Child, Preschool
- Cold Temperature/adverse effects
- Diagnosis, Differential
- Eosinophilia/blood
- Eosinophilia/epidemiology
- Eosinophilia/pathology
- Eosinophilia/therapy
- Erythema Nodosum/blood
- Erythema Nodosum/diagnosis
- Erythema Nodosum/epidemiology
- Erythema Nodosum/pathology
- Erythema Nodosum/therapy
- Fat Necrosis/blood
- Fat Necrosis/epidemiology
- Fat Necrosis/pathology
- Fat Necrosis/therapy
- Granuloma Annulare/blood
- Granuloma Annulare/epidemiology
- Granuloma Annulare/pathology
- Granuloma Annulare/therapy
- Humans
- Infant
- Infant, Newborn
- Lymphoma, T-Cell, Cutaneous/blood
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/pathology
- Lymphoma, T-Cell, Cutaneous/therapy
- Panniculitis/classification
- Panniculitis/diagnosis
- Panniculitis/epidemiology
- Panniculitis/etiology
- Panniculitis/pathology
- Panniculitis/therapy
- Panniculitis, Nodular Nonsuppurative/blood
- Panniculitis, Nodular Nonsuppurative/epidemiology
- Panniculitis, Nodular Nonsuppurative/pathology
- Panniculitis, Nodular Nonsuppurative/therapy
- Sclerema Neonatorum/blood
- Sclerema Neonatorum/epidemiology
- Sclerema Neonatorum/pathology
- Sclerema Neonatorum/therapy
- Subcutaneous Fat/pathology
- alpha 1-Antitrypsin Deficiency/complications
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Affiliation(s)
- S Grassi
- Dipartimento di Scienze Clinico-Chirurgiche Diagnostiche e Pediatriche, Sezione di Dermatologia Università di Pavia, Fondazione IRCCS Policlinico "San Matteo", Pavia, Italia -
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Wright A, Wijeratne A, Hung T, Gao W, Whittaker S, Morris S, Scarisbrick J, Beynon T. Prevalence and severity of pruritus and quality of life in patients with cutaneous T-cell lymphoma. J Pain Symptom Manage 2013; 45:114-9. [PMID: 22917715 DOI: 10.1016/j.jpainsymman.2012.01.012] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 12/30/2011] [Accepted: 02/08/2012] [Indexed: 11/26/2022]
Abstract
CONTEXT Cutaneous T-cell lymphoma (CTCL), although rare, is associated with a significant symptom burden. Pruritus appears to be one of the most prominent and disturbing symptoms. OBJECTIVES To describe the prevalence and severity of pruritus and quality of life (QOL) in patients with CTCL. METHODS Patients with CTCL able to complete two questionnaires were invited to complete a visual analogue scale for itch (VAS(itch)) and the Skindex-29. Prevalence of pruritus, mean score, and SD were estimated for the VAS(itch) and Skindex-29, and the Pearson's correlation coefficient was calculated to evaluate the relationship between severity of pruritus and QOL. RESULTS One hundred patients were recruited (mean [SD] age 57.9 [12.9] years, range 30-86 years). Eighty-eight percent reported pruritus in the preceding four weeks, 46% indicating that it was often or always a problem. The mean (SD) of VAS(itch) (n=92) was 3.2 (3.2), range zero to 10. The mean (SD) total Skindex-29 score was 43.3 (27.7). More advanced disease stage was associated with poorer QOL. The Skindex-29 correlated strongly with the VAS(itch) (Pearson's correlation coefficient=0.72, P<0.001). CONCLUSION All aspects of QOL are affected in CTCL. Pruritus is a common and troublesome symptom. A more advanced disease stage and more severe pruritus symptoms were associated with poorer QOL in this study.
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Affiliation(s)
- Abigail Wright
- St. Thomas' Hospital, King's Health Partners, London, United Kingdom
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31
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Fernandez-Peñas P. Potent topical steroids are one of the treatments for cutaneous T-cell lymphoma. J Allergy Clin Immunol 2010; 126:414; author reply 414-5. [PMID: 20621338 DOI: 10.1016/j.jaci.2010.04.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2010] [Accepted: 04/29/2010] [Indexed: 11/30/2022]
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32
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Kuiper RV, Kimpfler S, Grinwis GCM. Case report: epitheliotropic lymphoma in a zebrafish (Danio rerio). Tijdschr Diergeneeskd 2009; 134:1018-1020. [PMID: 20120336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A proliferative disorder of lymphocytes was observed in a macroscopically normal young adult wild-type zebrafish (Danio rerio) during routine histological screening in a two-generation toxicity study. Proliferating lymphocytes were observed to invade the gill arches, infiltrate the cranial skeletal muscle and inner ear, and accumulate at distant sites in the frontal epidermis. The test compound, tetrabromobisphenol A (TBBPA, a flame retardant), is not known as a carcinogen and no tumours were detected in any of the 53 other fish in the study, including tank mates. Although neoplastic lymphoid proliferation in the thymus region is occasionally observed, we have never seen epitheliotropism in zebrafish during other similar exposure studies or brood stock. Our findings indicate that epitheliotropic lymphoma can occur spontaneously in zebrafish but at a low incidence.
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Affiliation(s)
- R V Kuiper
- Dutch Molecular Pathology Center, Pathobiology Department, Faculty of Veterinary Medicine, Utrecht University, Yalelaan I, P.O. Box 80,158, 3508 TD Utrecht, The Netherlands
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33
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Bagot M. Cutaneous T-cell lymphoma. Preface. Dermatol Clin 2008; 26 Suppl 1:V. [PMID: 18405179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Abstract
OBJECTIVE To describe incidence trends for cutaneous T-cell lymphoma (CTCL) in the United States. DESIGN Population-based study. SETTING Data were obtained from 13 population-based cancer registries of the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute from 1973 through 2002. PARTICIPANTS A total of 4783 cases of CTCL were identified for the period 1973 through 2002. MAIN OUTCOME MEASURE Diagnosis of CTCL. RESULTS The overall annual age-adjusted incidence of CTCL was 6.4 per million persons. Annual incidence increased by 2.9 x 10(-6) per decade over the study period. Incidence was higher among blacks (9.0 x 10(-6)) than among whites (6.1 x 10(-6)) and was higher among men (8.7 x 10(-6)) than among women (4.6 x 10(-6)). The racial differences in incidence decreased with age, while the sex differences increased with age and decreased over time. Substantial geographic variation in incidence was found. Incidence was correlated with high physician density, high family income, high percentage of population with a bachelor's degree or higher, and high home values. Changes in International Classification of Diseases for Oncology (ICD-O) morphologic definitions have resulted in the redistribution of the cases of CTCL among specific subclassifications. CONCLUSIONS The continued rise in incidence of CTCL is substantial, and the cause of this increase is unknown. The racial, ethnic, sex, and geographic differences in incidence may be of etiologic importance. Changes in ICD-O definitions have made it difficult to evaluate incidence trends for subclassifications of CTCL such as mycosis fungoides. In addition, these changes resulted in the creation of ambiguous histologic codes, which may have caused coding errors. These errors along with the lack of independent verification are limitations of our study. An epidemiological investigation using population-based data is important to better understand this disorder.
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Affiliation(s)
- Vincent D Criscione
- Dermatoepidemiology Unit-111D, VA Medical Center, 830 Chalkstone Ave, Providence, RI 02908-4799, USA.
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35
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Rosen ST. Advances in the treatment of primary cutaneous T-cell lymphoma. Clin Adv Hematol Oncol 2007; 5:347-8. [PMID: 17673888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Steven T Rosen
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois 60611, USA
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37
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Yasukawa K, Kato N, Kodama K, Hamasaka A, Hata H. The spectrum of cutaneous lymphomas in Japan: a study of 62 cases based on the World Health Organization Classification. J Cutan Pathol 2006; 33:487-91. [PMID: 16872471 DOI: 10.1111/j.1600-0560.2006.00460.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The relative incidence of malignant lymphoma subtypes differs according to geographic location. This study investigated the epidemiology of cutaneous lymphoma subtypes in Japan and compared it with other countries. METHODS Sixty-two patients with cutaneous lymphoma attending the Department of Dermatology, National Hospital Organization Hokkaido Cancer Center were reviewed. The World Health Organization classification of hematopoietic and lymphoid malignancies was adopted. RESULTS Of the 62 patients, 31 had primary cutaneous lymphoma (PCL) and 31 had secondary cutaneous lymphoma (SCL). T- and natural killer (NK)-cell lymphoma accounted for 80% of PCL, of which, mycosis fungoides accounted for almost 35%. Of the 31 patients with secondary cutaneous lymphoma, 17 patients (54%) had T- and NK-cell lymphoma, including nine adult T-cell leukemia/lymphoma patients, and 14 patients (46%) had B-cell lymphoma, including 11 diffuse large B-cell lymphoma patients. The majority of patients with SCL and NK-cell lymphoma with primary or secondary skin lesions had a poor outcome. CONCLUSIONS PCL in this study showed a similar incidence to that of other institutions in Japan, while also demonstrating different frequencies from that of other countries, suggesting that the relative frequency of different PCL subtypes differ according to geographical location, similar to previous reports of systemic malignant lymphoma.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Female
- Humans
- Incidence
- Japan/epidemiology
- Killer Cells, Natural/pathology
- Leukemia, T-Cell/classification
- Leukemia, T-Cell/epidemiology
- Leukemia, T-Cell/pathology
- Lymphoma/classification
- Lymphoma/epidemiology
- Lymphoma/pathology
- Lymphoma, B-Cell/classification
- Lymphoma, B-Cell/epidemiology
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/classification
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, T-Cell, Cutaneous/classification
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/pathology
- Male
- Middle Aged
- Mycosis Fungoides/classification
- Mycosis Fungoides/epidemiology
- Mycosis Fungoides/pathology
- Retrospective Studies
- Sezary Syndrome/classification
- Sezary Syndrome/epidemiology
- Sezary Syndrome/pathology
- Skin Neoplasms/classification
- Skin Neoplasms/epidemiology
- Skin Neoplasms/pathology
- World Health Organization
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Affiliation(s)
- Kana Yasukawa
- Department of Dermatology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan.
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Vargo N. Cutaneous malignancies: KA, CTCL, and KS. Dermatol Nurs 2006; 18:270, 277. [PMID: 16856684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
MESH Headings
- Biopsy
- Diagnosis, Differential
- Disease Progression
- Humans
- Keratoacanthoma/epidemiology
- Keratoacanthoma/pathology
- Keratoacanthoma/therapy
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/pathology
- Lymphoma, T-Cell, Cutaneous/therapy
- Remission, Spontaneous
- Sarcoma, Kaposi/epidemiology
- Sarcoma, Kaposi/pathology
- Sarcoma, Kaposi/therapy
- Skin Neoplasms/epidemiology
- Skin Neoplasms/pathology
- Skin Neoplasms/therapy
- United States/epidemiology
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Affiliation(s)
- Nancy Vargo
- Oregon Health & Science University, Department of Dermatology, Portland, OR, USA
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Wilkins K, Turner R, Dolev JC, LeBoit PE, Berger TG, Maurer TA. Cutaneous malignancy and human immunodeficiency virus disease. J Am Acad Dermatol 2006; 54:189-206; quiz 207-10. [PMID: 16443048 DOI: 10.1016/j.jaad.2004.11.060] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2004] [Revised: 11/22/2004] [Accepted: 11/22/2004] [Indexed: 12/21/2022]
Abstract
UNLABELLED Certain skin cancers occur with increased frequency or altered course in patients infected with HIV. Malignant melanoma and squamous cell carcinoma are examples of cutaneous malignancies that have a more aggressive course in patients with HIV. Others, such as basal cell carcinoma, appear more frequently in this population but do not appear to be more aggressive. The incidence of HIV-associated Kapsosi's sarcoma has markedly decreased since the advent of HIV antiretroviral therapy. Our understanding of the pathogenesis of this malignancy and its unique management issues are fully reviewed. Cutaneous T-cell lymphoma (CTCL) is rare in this population. Other types of cutaneous lymphoma and HIV-associated pseudo-CTCL are discussed. This article addresses prevention, treatment, and follow-up strategies for this at-risk population. LEARNING OBJECTIVE At the completion of this learning activity, participants should be familiar with the unique epidemiology, clinical course, and management of cutaneous malignancy in patients infected with HIV.
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MESH Headings
- Algorithms
- Animals
- Anti-Retroviral Agents/administration & dosage
- Anus Neoplasms/epidemiology
- Anus Neoplasms/pathology
- Carcinoma, Basal Cell/epidemiology
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/therapy
- HIV Infections/drug therapy
- HIV Infections/epidemiology
- Herpesviridae Infections/epidemiology
- Herpesvirus 8, Human/isolation & purification
- Humans
- Immunity, Cellular
- Immunohistochemistry
- Lymphoma, Large-Cell, Anaplastic/epidemiology
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/immunology
- Lymphoma, T-Cell, Cutaneous/pathology
- Melanoma/epidemiology
- Melanoma/therapy
- Papillomaviridae
- Papillomavirus Infections/epidemiology
- Risk Factors
- Sarcoma, Kaposi/drug therapy
- Sarcoma, Kaposi/epidemiology
- Seroepidemiologic Studies
- Skin Neoplasms/epidemiology
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Affiliation(s)
- Karl Wilkins
- Department of Dermatology, University of California-San Francisco, California, USA.
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Abstract
BACKGROUND Cutaneous T-cell lymphoma (CTCL) can have a profound impact on a patient's health-related quality of life; however, little is known about its actual impact. The authors evaluated patients' perspectives on the impact of CTCL on physical functioning, lifestyle, emotional well being, and satisfaction with treatment. METHODS A 4-page, self-administered questionnaire was mailed and made available online in March 2005 to the entire United States membership of the Mycosis Fungoides Foundation (n = 930 members). Outcome measures were patients' perspectives on the psychosocial impact of CTCL and the management of their disease. RESULTS The response rate was 68%, and 93.6% of respondents were white. The majority of respondents had mycosis fungoides (89%). Respondents were bothered by skin redness (94%) and by the extent of symptoms that affected their choice of clothing (63%). For most patients, the disease had a functional impact, rendering them tired or affecting their sleep. Health distress was reported by almost all respondents, with 94% reporting that they worried about the seriousness of their disease and 80% worrying about dying from the disease. Sixty-two percent of respondents reported that their disease made them feel unattractive, 85% reported that their treatment made their disease seem more manageable, but 61% reported that they felt burdened financially by their disease. CONCLUSIONS The high response rate and patients' responses to the survey provided compelling evidence that patients believed CTCL had a profound and severe impact on their functioning, emotional, and social well being. A striking health distress was prevalent in almost all respondents. Although the majority of patients reported that treatments made their disease more manageable, a significant proportion reported that they felt burdened financially by their disease.
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Affiliation(s)
- Marie-France Demierre
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts 02118, USA.
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Tani M, Fina M, Alinari L, Stefoni V, Baccarani M, Zinzani PL. Phase II trial of temozolomide in patients with pretreated cutaneous T-cell lymphoma. Haematologica 2005; 90:1283-4. [PMID: 16154858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Between July 2003 and March 2004, nine patients with pretreated mycosis fungoides were enrolled into a phase II trial and were treated with temozolomide. The overall response rate was 33%. Further studies are needed to test the efficacy of temozolomide, alone or in combination in earlier stages of this disease.
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Abstract
The term cutaneous T-cell lymphoma (CTCL) describes a heterogeneous group of neoplasms of skin-homing T-cells that vary considerably in clinical presentation, histologic appearance, immunophenotype, and prognosis. CTCL represent approximately 75-80% of all primary cutaneous lymphomas, whereas primary cutaneous B cell lymphomas account for approximately 20-25%. For many years mycosis fungoides and Sézary's syndrome were the only known types of CTCL. In the last decade, based on a combination of clinical, histological, and immunophenotypical criteria, new types of CTCL have been defined and new classifications for this group of primary cutaneous lymphomas have been formulated. In this overview, characteristic features of the different types of CTCL recognized in the European Organization for Research and Treatment of Cancer (EORTC) classification for primary cutaneous lymphomas and the World Health Organization (WHO) classification will be reviewed. Key conclusions from this brief overview are: (1) that the term CTCL does not refer to a single disease entity, but to a group of diseases with different clinical behaviors, therapeutic requirements, and prognoses; (2) that diagnosis and classification should always be based on a combination of clinical, histologic, and immunologic criteria; and (3) that the WHO and EORTC classification schemes are broadly equivalent for almost 90% of CTCL patients. Key research priorities are to develop effective therapies for peripheral T-cell lymphoma, extranodal NK (natural killer) T-cell lymphoma and so-called blastic NK cell lymphoma, and to determine molecular profiles for all forms of CTCL.
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Affiliation(s)
- Rein Willemze
- Department of Dermatology, University of Leiden Medical Center, PO Box 9600, Leiden 2300 RC, The Netherlands.
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Affiliation(s)
- Robert Gniadecki
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.
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Abstract
Cutaneous lymphomas are rare in young patients and are mostly represented by mycosis fungoides and its variants and CD30+ lymphoproliferative disorders (lymphomatoid papulosis [LYP] and anaplastic large T-cell lymphoma). We report our observations in a series of 69 patients less than 20 years of age who presented either with primary cutaneous lymphoma (n = 62) or with secondary manifestations of extracutaneous disease (n = 7). Clinicopathologic features permitted classification of the cases into the following diagnostic categories: mycosis fungoides (n = 24, all primary cutaneous), anaplastic large T-cell lymphoma (n = 13, all primary cutaneous), LYP (n = 11, all primary cutaneous), subcutaneous "panniculitis-like" T-cell lymphoma (n = 1, primary cutaneous), small-medium pleomorphic T-cell lymphoma (n = 2, all primary cutaneous), natural killer (NK)/T-cell lymphoma, nasal-type (n = 1, secondary cutaneous), follicle center cell lymphoma (n = 1, primary cutaneous), marginal zone B-cell lymphoma (n = 7, all primary cutaneous), B-lymphoblastic lymphomas (n = 6, 3 primary and 3 secondary cutaneous), specific cutaneous manifestations of Hodgkin disease (n = 1, secondary cutaneous), and acute myeloid leukemia (n = 2, both secondary cutaneous). Cutaneous lymphoma in children should be differentiated from benign skin disorders that may simulate them. In particular, mycosis fungoides and LYP in this age group may present with clinicopathologic features reminiscent of inflammatory disorders such as pityriasis alba, vitiligo, pityriasis rosea, and pityriasis lichenoides et varioliformis acuta. Even in secondary cutaneous lymphomas, skin manifestations may be the first sign of the systemic disease, and a diagnosis may be achieved on examination of histopathologic specimens of a cutaneous lesion. Our study illustrates the wide spectrum of cutaneous lymphomas and leukemias in patients less than 20 years of age and underlines the need for proper interpretation of these lesions by dermatologists and dermatopathologists.
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Abstract
The clinicopathologic characteristics of malignant lymphomas vary according to geography. The aim of this study was to determine the relative frequency of cutaneous lymphomas and to examine the clinical relevance of the WHO classification in Korean cases of cutaneous lymphoma. The Korean Dermatopathology Research Group conducted a clinicopathologic review of a nationwide collection of 80 cutaneous lymphomas, diagnosed at 23 institutes over a recent 3-year period. The clinical records, haematoxylin & eosin-stained slides and immunohistochemical stains from 80 patients with malignant lymphomas of the skin were reviewed. In our study, the most frequent cutaneous lymphoma was mycosis fungoides. Compared with Western countries, Korea had higher rates of NK/T cell lymphoma and subcutaneous panniculitis-like T-cell lymphoma and a much lower rate of B-cell lymphoma. The occurrence rates for various subtypes of malignant lymphoma in Korea are distinct from those in Western countries. The EORTC classification is not fully appropriate in dealing with Korean cases of cutaneous lymphoma, because NK/T cell lymphoma is not included in the EORTC classification for cutaneous lymphoma.
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Affiliation(s)
- M-W Lee
- Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
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Tan SH, Sim CS, Ong BH. Cutaneous lymphomas other than mycosis fungoides in Singapore: a clinicopathological analysis using recent classification systems. Br J Dermatol 2003; 149:542-53. [PMID: 14510987 DOI: 10.1046/j.1365-2133.2003.05476.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Cutaneous lymphomas other than mycosis fungoides (MF) are a heterogeneous group with wide variations in clinical presentation, biological behaviour and prognosis. New classification systems have been designed or proposed in recent years, with well-defined disease entities and emphasis on the importance of site. OBJECTIVES This study aims to analyse a series of non-MF lymphomas in an institution-based dermatological setting in Singapore, based on the European Organization for Research and Treatment of Cancer (EORTC) classification and the World Health Organization (WHO) classification. A secondary objective is to highlight the clinical utility of both classification systems. PATIENTS AND METHODS Forty cases diagnosed over a 12-year period were examined by immunohistochemistry with antibodies targeting CD3, CD4, CD5, CD8, CD20, CD30, CD43, CD45RO, CD56 and CD68 in paraffin-embedded specimens. The immunohistological diagnosis was correlated with the clinical presentation and staging investigations for the final diagnosis and the course of disease recorded. RESULTS Non-MF T-cell lymphomas presenting in the skin comprised 31 cases (78%) and were 3(1/2) times more common than B-cell lymphomas, which comprised nine cases (22%). The common subtypes were lymphomatoid papulosis, CD30+ large cell cutaneous T-cell lymphoma and subcutaneous panniculitis-like T-cell lymphoma. The commonly ascribed B-cell pattern with infiltrates in the mid and deep dermis and perivascular spaces was seen in 60% of T-cell lymphomas. Overall, there were equal numbers of primary cutaneous T-cell lymphomas and those due to concurrent or secondary cutaneous lymphoma. Five of six cases of subcutaneous panniculitis-like T-cell lymphoma had concurrent cutaneous and systemic involvement and their median survival was 7 months. CONCLUSIONS The predominance of cutaneous T-cell lymphomas in this case series closely matched that reported from east Asia; cutaneous B-cell lymphomas are much less common than in Europe. The EORTC classification, which is designed only for primary cutaneous lymphomas, should be used in conjunction with the WHO classification because of the high prevalence of cutaneous lymphomas as the secondary site of disease from systemic lymphoma. In addition, subcutaneous panniculitis-like T-cell lymphoma is a primary cutaneous lymphoma where systemic involvement is common at initial presentation. We propose full immunophenotyping and complete clinical evaluation with staging investigations for all patients presenting with cutaneous lymphomas other than MF.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Child
- Female
- Humans
- Lymphoma, B-Cell/epidemiology
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/pathology
- Male
- Middle Aged
- Singapore/epidemiology
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Affiliation(s)
- S H Tan
- Institute of Dermatology Singapore, National Skin Centre, 1 Mandalay Road, Singapore 308205.
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Abstract
Male gender is interpreted as a risk factor for developing mycosis fungoides and perhaps other cutaneous and extracutaneous lymphomas. In this review the authors examine epidemiologic, clinical, pathologic, and molecular data in an effort to understand whether and to what extent gender or sex hormones are involved in the pathogenesis of lymphoproliferative disorders.
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Affiliation(s)
- Yonit Wohl
- Department of Dermatology, Tel Aviv-Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Diagnosis, Differential
- Female
- Germany/epidemiology
- Humans
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/drug therapy
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/genetics
- Lymphoma, T-Cell, Cutaneous/immunology
- Lymphoma, T-Cell, Cutaneous/mortality
- Lymphoma, T-Cell, Cutaneous/pathology
- Lymphoma, T-Cell, Cutaneous/therapy
- Male
- Middle Aged
- Multicenter Studies as Topic
- Mycosis Fungoides/diagnosis
- Mycosis Fungoides/pathology
- Mycosis Fungoides/therapy
- Neoplasm Staging
- PUVA Therapy
- Photopheresis
- Randomized Controlled Trials as Topic
- Registries
- Sezary Syndrome/diagnosis
- Sezary Syndrome/therapy
- Skin/pathology
- Skin Neoplasms/diagnosis
- Skin Neoplasms/drug therapy
- Skin Neoplasms/epidemiology
- Skin Neoplasms/genetics
- Skin Neoplasms/immunology
- Skin Neoplasms/mortality
- Skin Neoplasms/pathology
- Skin Neoplasms/therapy
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Affiliation(s)
- Edgar Dippel
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Mannheim, Ruprecht-Karls Universität Heidelberg.
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Abstract
Effective long-term management of cutaneous T-cell lymphoma (CTCL) requires administration of skin-directed therapies such as topically applied nitrogen mustard or photochemotherapy to achieve a complete response in clinically early disease (patch and thin-plaque-phase mycosis fungoides, MF) and often the concomitant administration of well-tolerated drugs with systemic effects such as interferon alfa, bexarotene, methotrexate or extracorporeal photopheresis in more advanced, but not highly aggressive/nontransformed disease (thick plaque or tumor phase MF or erythrodermic CTCL). The author's approach is provided as a guide for dermatologists in private practice.
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