Mycosis fungoides is the most common type of cutanoues T-cell Lymphoma. It is a mature T-cell non-Hodgkin lymphoma with presentation in the skin but with potential involvement of the nodes, blood, and viscera. This case reports a 24-year-old female who presented with a two-year history of progressively increasing hypopigmented macules and patches. Skin punch biopsy and immunohistochemical stains done were suggestive of a malignant T-cell process. The patient was managed with a short course topical corticosteroids and maintained on a topical moisturizer. The patient underwent multiple sessions of narrowband UV-B Phototherapy at 2-3 times per week and showed significant improvement of the skin lesions hence, was advised to be maintained on phototherapy.

Mycosis fungoides (MF) is a primary cutaneous T-cell lymphoma that may, although rarely, present as asymptomatic hypopigmented lesions. On the other hand, vitiligo is an autoimmune disorder characterized by asymptomatic depigmented patches. Few reports have documented both conditions occurring in a single patient, making this an intriguing diagnostic and management dilemma.

This is a case of a 26-year old female with a 10-year history of persistent hypopigmented, depigmented and erythematous patches and thin plaques [Figures 1a and 2a]. Histopathology showed epidermotropism of mononuclear cells on H&E stain [Figure 3] and a positive CD-3 stain for T cells, confirming mycosis fungoides [Figure 4b]. No evidence of lymphadenopathy and visceral involvement was found on both the chest and abdominal CT scans. The depigmented patches were likewise biopsied showing lack of Melan-A staining and absence of epidermal melanocytes, consistent with vitiligo [Figure 4a]. Final diagnoses were both mycosis fungoides, stage IB and vitiligo. The patient underwent narrowband UVB phototherapy and was started on topical corticosteroids [Figures 1b and 2b]. Improvement was evident over a three-month period, with body surface area decreasing from 77% to 46%. As the patient is young, has normal LDH levels, and shows no signs of extracutaneous disease, prognosis is promising.

This rare case of mycosis fungoides and vitiligo occurring together presents notable diagnostic and management challenges. Some studies hypothesize that the aberrant T cells involved in MF might contribute to the T cell-mediated destruction of melanocytes, similar to the mechanisms seen in vitiligo.

Mycosis Fungoides is the most common type of primary cutaneous lymphoma. Early in its course, it usually presents as erythematous patches and plaques similar to a lot of cutaneous conditions. A 68-year-old male presented with a 13-year history of multiple erythematous patches and plaques on the arms and trunk. The lesions were pruritic and chronically relapsing over the years, temporarily relieved by topical corticosteroids. Thereafter, there was onset of multiple nodules on the trunk, extremities and face. Initial biopsy was done by a different dermatologist, revealed Hansen’s Disease, Borderline Borderline spectrum. Fitefaraco stain was positive but no bacillary index was given. The patient was subsequently started on rifamcpicin 600mg/capsule once a day, Ofloxacin 400mg/tablet once a day, and Minocycline 100mg/capsule once a day. The lesions were noted to worsen, eventually developing ulcerations over the trunk and extremities prompting referral to our institution. The biopsy results were as follows: Cutaneous T-Cell Lymphoma, diffuse cluster of differentiation (CD) 3 staining, focal CD20 staining, and negative FiteFaraco stain. The histopathologic findings combined with the clinical presentation led to the diagnosis of Mycosis Fungoides. He was then referred to medical oncology for proper staging and definitive management. The prognosisof Mycosis Fungoides is generally dependent on the stage as determined by the extent of skin involvement as well as presence of lymph node invasion and/or metastasis.
Mycosis Fungoides ; Lymphoma ; T-Cell ; Cutaneous

No abstract available.
Mycosis Fungoides

BACKGROUND: The occurrence of cutaneous malignant tumors has been increasing worldwide due to changes in various environmental factors. OBJECTIVE: Our study aimed to analyze the overall tendency of clinical characteristics in single-center patients with cutaneous malignant tumors according to sex, age, duration, size, anatomic site, treatment, and concomitant diseases. METHODS: We retrospectively reviewed the medical records and clinical photographs of 319 patients diagnosed with cutaneous malignant tumors (basal cell carcinoma, squamous cell carcinoma, melanoma, lymphoma, Paget's disease, metastatic skin cancer, mycosis fungoides, angiosarcoma, dermatofibrosarcoma protuberans, Kaposi sarcoma, malignant fibrous histiocytoma, Merkel cell carcinoma) and 109 patients diagnosed with premalignant tumors (Bowen's disease) between January 2007 and January 2017. RESULTS: The average annual incidence of malignant cutaneous tumors was 2.4%. In total, 158 males (36.9%) and 270 females (63.1%) were included with a mean age of onset of 66 years. Among the malignant tumors, basal cell carcinoma (30.8%) was the most common, while the incidences of squamous cell carcinoma (18.9%), melanoma (6.3%), and lymphoma (4.4%) were also high. The predominantly involved anatomic sites were the face (67.3%), trunk (11.5%), and legs (10.9%). Most cases involved solitarily existing tumors (77.3%), and pruritus (21.7%) was the most common accompanying symptom. Among the 69.6% of patients who received treatment for their tumors, the most common method was surgical removal. No significant increase in concomitant diseases or environmental factors was detected. CONCLUSION: Our study is meaningful as an overall and recent review of various types of cutaneous malignancies that provides preliminary data for further large-scale nationwide studies.
Age of Onset ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Chungcheongnam-do ; Dermatofibrosarcoma ; Female ; Hemangiosarcoma ; Histiocytoma, Malignant Fibrous ; Humans ; Incidence ; Leg ; Lymphoma ; Male ; Medical Records ; Melanoma ; Methods ; Mycosis Fungoides ; Pruritus ; Retrospective Studies ; Sarcoma, Kaposi ; Skin Neoplasms ; Statistics as Topic

PURPOSE: We aimed to evaluate clinical outcomes including progression-free survival (PFS), overall survival (OS), partial response, and complete response in patients who underwent radiation therapy (RT) for mycosis fungoides (MF). Also, we sought to find prognostic factors for clinical outcomes. MATERIALS AND METHODS: Total 19 patients confirmed with MF between 1999–2015 were retrospectively reviewed. Clinical and treatment characteristics, clinical outcomes, and and toxicities were analyzed. RESULTS: Eleven patients were treated with total skin electron beam radiotherapy (TSEBT) and 8 patients with involved field radiation therapy (IFRT) with median dose of 30 Gy, respectively. The median time interval from diagnosis to RT was 2.6 months (range, 0.4 to 87.3 months). The overall response rate was 100%; 11 patients (57.9%) had a complete response and 8 patients (42.1%) a partial response. The presence of positive lymph node at the time of consultation of RT was associated with lower OS (p = 0.043). In multivariate analysis, PFS was significantly lower for patients with increased previous therapies experienced following RT (p = 0.019) and for patients showing PR during RT (p = 0.044). There were no reported grade 3 or more skin toxicities related with RT. CONCLUSION: Both IFRT and TSEBT are effective treatment for MF patients. Patients with short disease course before RT or complete response during RT are expected to have longer PFS. Positive lymph node status at the initiation of RT was associated woth poor OS, suggesting other treatment modalities such as low-dose RT for patients with low life-expectancy.
Diagnosis ; Disease-Free Survival ; Humans ; Lymph Nodes ; Lymphoma, T-Cell, Cutaneous ; Multivariate Analysis ; Mycosis Fungoides ; Radiotherapy ; Retrospective Studies ; Skin

BACKGROUND: Folliculotropic mycosis fungoides (FMF) is a variant of mycosis fungoides (MF) that is characterized clinically by variable types of skin eruptions, including plaques, acneiform lesions, and alopecic patches. Histopathologically, FMF is characterized by folliculotropic infiltrates. OBJECTIVE: This study was conducted to scrutinize the clinical and histopathologic features of FMF in Koreans and the responses to phototherapy. METHODS: Twenty Koreans diagnosed with MF who had histopathologic evidence of folliculotropism were enrolled. RESULTS: Eighteen patients had head-and-neck-region infiltration, while five had solitary lesion. In all patients, the atypical lymphocytic infiltrate had a perifollicular distribution. Twelve patients were treated with ultraviolet A (UVA)-1. Eleven of these 12 patients with early-stage FMF experienced >80% improvement (8: complete remission; 3: partial remission). Four patients, including 2 who relapsed after UVA-1, were treated with photodynamic therapy (PDT), reaching complete remission after PDT. CONCLUSION: As FMF has variable clinical presentations, skin biopsy is required to confirm the diagnosis. And both UVA-1 and methyl aminolevulinate-PDT are clinically effective in treatment of early-stage FMF.
Biopsy ; Diagnosis ; Humans ; Mycosis Fungoides* ; Photochemotherapy* ; Phototherapy ; Skin

No abstract available.
Lymphoma, T-Cell* ; Mycosis Fungoides* ; T-Lymphocytes*

Mycosis fungoides is the most common type of cutaneous T-cell lymphoma. Patients with early stage disease usually respond well to conventional therapies, with a relatively favorable prognosis. However, a few patients are refractory to treatment and need alternative strategies, even at the patch and plaque stages. We report the case of a middle-aged woman with long-standing and refractory mycosis fungoides that responded to combination therapy with the 308-nm excimer laser and oral alitretinoin.
Female ; Humans ; Lasers, Excimer ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides* ; Phototherapy* ; Prognosis

Introduction: Folliculotropic mycosis fungoides is a rare and aggressive subtype of mycosis fungoides characterized by small to medium-sized malignant T-cells that typically infiltrate the hair follicle. It represents 4% of primary cutaneous lymphomas and less than 10% of patients with MF. Case Summary: We report 2 cases of 80-year old female, who presented with a 3-year history of an erythematous plaque on the left infraorbital area and forehead, and the other with an 8-month history of multiple erythematous indurated plaques on the left cheek, left eyebrow and malar area. Clinical presentation, histopathology and immunohistochemistry findings revealed a diagnosis of folliculotropic mycosis fungoides. Conclusion Folliculotropic mycosis fungoides has distinct clinical and microscopic features. Evaluation of clinical, pathologic, and immunophenotypic findings are important to identify this rare form of cutaneous T-cell lymphoma.
Mycosis Fungoides ; Lymphoma, T-Cell, Cutaneous ; Mucinosis, Follicular