A study of clinicopathologic profile of 15 cases of hypopigmented mycosis fungoides
Date
2011-10-06
Journal Title
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Publisher
Medknow Publications on behalf of The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL)
Abstract
Description
Background: Mycosis fungoides (MF) is cutaneous lymphoma of the T-cell
lineage. Hypopigmented MF is a clinical variant of MF, described mainly
in Asians. This is a retrospective clinicopathologic analysis of
hypopigmented MF at a tertiary care center. Aims: To describe the
clinicopathologic profile of hypopigmented MF. Methods: Records of
clinicopathologic notes over a 5-year period ranging from January 2005
up to December 2009 were reviewed over a period of 3 months, of which
15 cases were diagnosed with hypopigmented MF based on
clinicopathologic correlation. Results: Hypopigmented MF was found to
be more common in males, and between second and fourth decades of life.
The latent period between onset and diagnosis was around 3.83 years.
Most of the patients were asymptomatic 80% (12/15), with skin changes
of subtle atrophy in 46.66% (7/15), scaling in 20% (3/15) and focal
changes of poikiloderma in 26.66% (4/15) patients. Most common sites of
distribution of the lesions were the trunk and extremities. Many of the
cases had been clinically mistaken for Hansen′s disease prior to
correct diagnosis. Marked epidermotropism and tagging of epidermis by
large lymphocytes characterizes the condition histopathologically. Of
the 15 cases, immunohistochemistry was possible in 10 cases, of which 8
showed predominant CD8 positive epidermotropic infiltrates and two
cases showed absence of CD8 positive and CD4 positive lymphocytic
infiltrate in the epidermis. Conclusion: Hypopigmented MF presents as
hypopigmented asymptomatic patches without any erythema or infiltration
in its early stage and mimics Hansen′s disease. Skin biopsy
clinches the diagnosis.
Keywords
Hansen′s
disease, hypopigmented mycosis fungoides, Epidermotropism
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