Pityriasis Lichenoides-like Mycosis Fungoides: Clinical and Histologic Features and Response to Phototherapy
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background: Pityriasis lichenoides (PL)-like skin lesions rarely appear as a specific manifestation of mycosis fungoides (MF). Objective: We investigated the clinicopathological features, immunophenotypes, and treatments of PL-like MF. Methods: This study included 15 patients with PL-like lesions selected from a population of 316 patients diagnosed with MF at one institution. Results: The patients were between 4 and 59 years of age. Four patients were older than 20 years of age. All of the patients had early-stage MF. In all patients, the atypical lymphocytic infiltrate had a perivascular distribution with epidermotropism. The CD4/CD8 ratio was ＜1 in 12 patients. Thirteen patients were treated with either narrowband ultraviolet B (NBUVB) or psoralen+ultraviolet A (PUVA), and all of them had complete responses. Conclusion: PL-like MF appears to have a favorable prognosis and occurrence of this variant in adults is uncommon. MF should be suspected in the case of a PL-like skin eruption. Therefore, biopsy is required to confirm the diagnosis of PL-like MF, and NBUVB is a clinically effective treatment.
Abstract
Background: Pityriasis lichenoides (PL)-like skin lesions rarely appear as a specific manifestation of mycosis fungoides (MF). Objective: We investigated the clinicopathological features, immunophenotypes, and treatments of PL-like MF. Methods: This study included 15 patients with PL-like lesions selected from a population of 316 patients diagnosed with MF at one institution. Results: The patients were between 4 and 59 years of age. Four patients were older than 20 years of age. All of the patients had early-stage MF. In all patients, the atypical lymphocytic infiltrate had a perivascular distribution with epidermotropism. The CD4/CD8 ratio was ＜1 in 12 patients. Thirteen patients were treated with either narrowband ultraviolet B (NBUVB) or psoralen+ultraviolet A (PUVA), and all of them had complete responses. Conclusion: PL-like MF appears to have a favorable prognosis and occurrence of this variant in adults is uncommon. MF should be suspected in the case of a PL-like skin eruption. Therefore, biopsy is required to confirm the diagnosis of PL-like MF, and NBUVB is a clinically effective treatment.
참고문헌 (19)
- Jawed SI., "Primary cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome): part I. Diagnosis: clinical and histopathologic features and new molecular and biologic markers", J Am Acad Dermatol, 70, pp.205.e1~205.e16 (2014)
- Ahn CS., "Mycosis fungoides : an updated review of clinicopathologic variants", Am J Dermatopathol, 36, pp.933~948 (2014)
- Ko JW., "Pityriasis lichenoides-like mycosis fungoides in children", Br J Dermatol, 142, pp.347~352 (2000)
- 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)
- Pimpinelli N., "Defining early mycosis fungoides", J Am Acad Dermatol, 53, pp.1053~1063 (2005)
- de Unamuno Bustos B., "Adult pityriasis lichenoides-like mycosis fungoides : a clinical variant of mycosis fungoides", Int J Dermatol, 53, pp.1331~1338 (2014)
- Vonderheid EC., "Papular mycosis fungoides : a variant of mycosis fungoides or lymphomatoid papulosis?", J Am Acad Dermatol, 55, pp.177~180 (2006)
- Cerroni L, "Skin lymphoma: the illustrated guide" (2014), Wiley-Blackwell
- Magro C., "Pityriasis lichenoides : a clonal T-cell lymphoproliferative disorder", Hum Pathol, 33, pp.788~795 (2002)
- Rivers JK., "Pityriasis lichenoides-like lesions associated with poikiloderma : a precursor of mycosis fungoides", Br J Dermatol, 115, pp.17~ (1986)
- Dereure O., "T-Cell clonality in pityriasis lichenoides et varioliformis acuta : a heteroduplex analysis of 20 cases", Arch Dermatol, 136, pp.1483~1486 (2000)
- Massone C., "Histopathologic features of early(patch)lesions of mycosis fungoides : a morphologic study on 745 biopsy specimens from 427 patients", Am J Surg Pathol, 29, pp.550~560 (2005)
- 서기석, "Efficacy of Ultraviolet A1 Phototherapy in Recalcitrant Skin Diseases", Annals of Dermatology, 22(1), pp.1~8 (2010), 대한피부과학회
- Ozawa M., "312-nanometer ultraviolet B light(narrow-band UVB)induces apoptosis of T cells within psoriatic lesions", J Exp Med, 189, pp.711~718 (1999)
- 장민수, "Narrowband Ultraviolet B Phototherapy of Early Stage Mycosis Fungoides in Korean Patients", Annals of Dermatology, 23(4), pp.474~480 (2011), 대한피부과학회
- Krutmann J., "Mechanisms of ultraviolet(UV)B and UVA phototherapy", J Investig Dermatol Symp Proc, 4, pp.70~72 (1999)
- Jawed SI., "Primary cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome): part II. Prognosis, management, and future directions", J Am Acad Dermatol, 70, pp.223.e1~223.e17 (2014)
- Prince HM., "How I treat mycosis fungoides and Sézary syndrome", Blood, 114, pp.4337~4353 (2009)
- Wang SH., "Adult pityriasis lichenoides-like mycosis fungoides with high density of CD8-positive T-lymphocytic infiltration", J Eur Acad Dermatol Venereol, 21, pp.401~402 (2007)