A Case of Vesicular Mycosis Fungoides
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
A 44-year-old male presented with 7 months history of nonpruritic round oozing plaqueson the extremities and red papules on the trunk. The lesions were resistant to topical andoral steroid prescribed at the other local clinics. Histopathological examination showedparakeratosis with acanthosis and rete ridge elongation as well as spongiotic intraepidermalblisters and dense dermal infiltration of small to medium sized atypical lymphoid cells. Immunohistochemicalanalysis revealed the lymphocyte infiltrate to be predominantly CD4+ Tcells, with CD4/CD8 ratio to be greater than 10:1. Infiltration of large cells that were CD30+were also noted. This histopathologic findings are consistent with vesicular mycosis fungoides(MF). He was prescribed with narrow-band ultraviolet B twice per week and topicalsteroid, combined with interferon-α injection for 5 weeks, and his skin lesions significantlyfaded and were flattened. Vesicular MF is associated with poor prognosis, but our patientwas able to show benign course of disease thanks to timely diagnosis. One must considervesicular MF as a differential for recalcitrant eczematous lesions.
Abstract
A 44-year-old male presented with 7 months history of nonpruritic round oozing plaqueson the extremities and red papules on the trunk. The lesions were resistant to topical andoral steroid prescribed at the other local clinics. Histopathological examination showedparakeratosis with acanthosis and rete ridge elongation as well as spongiotic intraepidermalblisters and dense dermal infiltration of small to medium sized atypical lymphoid cells. Immunohistochemicalanalysis revealed the lymphocyte infiltrate to be predominantly CD4+ Tcells, with CD4/CD8 ratio to be greater than 10:1. Infiltration of large cells that were CD30+were also noted. This histopathologic findings are consistent with vesicular mycosis fungoides(MF). He was prescribed with narrow-band ultraviolet B twice per week and topicalsteroid, combined with interferon-α injection for 5 weeks, and his skin lesions significantlyfaded and were flattened. Vesicular MF is associated with poor prognosis, but our patientwas able to show benign course of disease thanks to timely diagnosis. One must considervesicular MF as a differential for recalcitrant eczematous lesions.
참고문헌 (12)
- Momtahen S, "Vesicular mycosis fungoides", Am J Dermatopathol, 37, pp.724~729 (2015)
- Hoppe RT, "Mycosis fungoides and the Sézary syndrome : pathology, staging, and treatment", Curr Probl Cancer, 14, pp.293~371 (1990)
- Olsen E, "Revisions to the staging and classification of mycosis fungoides and Sezary syndrome : a proposal of the International Society for Cutaneous Lymphomas(ISCL)and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer(EORTC)", Blood, 110, pp.1713~1722 (2007)
- Willemze R, "WHO-EORTC classification for cutaneous lymphomas", Blood, 105, pp.3768~3785 (2005)
- Willemze R, "The 2018 update of the WHO-EORTC classification for primary cutaneous lymphomas", Blood, 134, pp.1112~ (2019)
- Girardi M, "The pathogenesis of mycosis fungoides", N Engl J Med, 350, pp.1978~1988 (2004)
- Bowman PH, "Mycosis fungoides bullosa : report of a case and review of the literature", J Am Acad Dermatol, 45, pp.934~939 (2001)
- Elder DE, "Lever’s histopathology of the skin", pp.1135~1145 (2015), Lippincott William & Wilkins
- Porntharukcharoen S, "Large-cell transformed mycosis fungoides coexisting with mycosis fungoides bullosa : a case report and review of the literature", Case Rep Dermatol, 9, pp.243~248 (2017)
- Vergier B, "Transformation of mycosis fungoides : clinicopathological and prognostic features of 45 cases. French Study Group of Cutaneious Lymphomas", Blood, 95, pp.2212~2218 (2000)
- Patterson JW, "Weedon’s skin pathology", pp.1186~1188 (2016), Elsevier
- Kempf W, "Cutaneous CD30-positive T-cell lymphoproliferative disorders-clinical and histopathologic features, differential diagnosis, and treatment", Semin Cutan Med Surg, 37, pp.24~29 (2018)