Pityriasis Lichenoides-like Mycosis Fungoides: Clinical and Histologic Features and Response to Phototherapy

Overview

Journal Ann Dermatol

Specialty Dermatology

Date 2016 Oct 18

PMID 27746631

Citations 5

Authors

Min Soo Jang

Dong Young Kang

Jong Bin Park

Joon Hee Kim

Kwi Ae Park

Hark Rim

Kee Suck Suh

Affiliations

Soon will be listed here.

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.

Citing Articles

Pityriasis Lichenoides-Like Mycosis Fungoides: A Case Report.

Park L, Green C, Giansiracusa D, Hirt P, Ricotti C, Kerdel F Cureus. 2023; 15(3):e36665.

PMID: 37113344 PMC: 10129042. DOI: 10.7759/cureus.36665.

CD4/CD8 Dual Positive Pityriasis Lichenoides Like Mycosis Fungoides Presenting with Both Pityriasis Lichenoid Lesions and Hypopigmented Patches: A Rare Presentation.

Rao A, Naresh M, Shreeja V, Vsvn S, Sindhuja B, Pranaya B Indian J Dermatol. 2022; 67(4):441-444.

PMID: 36578738 PMC: 9792067. DOI: 10.4103/ijd.ijd_279_22.

Type D lymphomatoid papulosis with pityriasis lichenoides et varioliformis acuta-like features in a child with parvovirus infection: a controversial diagnosis in the spectrum of lymphoid proliferations: case report and literature review.

Calcaterra V, Cavalli R, Croci G, Fiori L, Fabiano A, Lunardon L Ital J Pediatr. 2022; 48(1):183.

PMID: 36307824 PMC: 9616621. DOI: 10.1186/s13052-022-01371-x.

A Case Report of Pityriasis Lichenoides-Like Mycosis Fungoides in Children: A Challenging Diagnosis.

Mohd Amin S, Muhamad R, Abdullah W, Zulkifli M, Bakrin I, Tangam T Korean J Fam Med. 2020; 42(4):334-338.

PMID: 32434301 PMC: 8321907. DOI: 10.4082/kjfm.20.0036.

Folliculotropic Mycosis Fungoides in 20 Korean Cases: Clinical and Histopathologic Features and Response to Ultraviolet A-1 and/or Photodynamic Therapy.

Jang M, Jang J, Park J, Kang D, Lee J, Lee T Ann Dermatol. 2018; 30(2):192-201.

PMID: 29606817 PMC: 5839891. DOI: 10.5021/ad.2018.30.2.192.

References

Dereure O, Levi E, Kadin M . T-Cell clonality in pityriasis lichenoides et varioliformis acuta: a heteroduplex analysis of 20 cases. Arch Dermatol. 2000; 136(12):1483-6. DOI: 10.1001/archderm.136.12.1483. View

de Unamuno Bustos B, Ferriols A, Sanchez R, Rabasco A, Vela C, Piris M . Adult pityriasis lichenoides-like mycosis fungoides: a clinical variant of mycosis fungoides. Int J Dermatol. 2014; 53(11):1331-8. DOI: 10.1111/ijd.12135. View

Magro C, Crowson A, Kovatich A, Burns F . Pityriasis lichenoides: a clonal T-cell lymphoproliferative disorder. Hum Pathol. 2002; 33(8):788-95. DOI: 10.1053/hupa.2002.125381. View

Jawed S, Myskowski P, Horwitz S, Moskowitz A, Querfeld C . 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. 2014; 70(2):205.e1-16. DOI: 10.1016/j.jaad.2013.07.049. View

Jawed S, Myskowski P, Horwitz S, Moskowitz A, Querfeld C . Primary cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome): part II. Prognosis, management, and future directions. J Am Acad Dermatol. 2014; 70(2):223.e1-17. DOI: 10.1016/j.jaad.2013.08.033. View

Ozawa M, Ferenczi K, Kikuchi T, Cardinale I, Austin L, Coven T . 312-nanometer ultraviolet B light (narrow-band UVB) induces apoptosis of T cells within psoriatic lesions. J Exp Med. 1999; 189(4):711-8. PMC: 2192929. DOI: 10.1084/jem.189.4.711. View

Krutmann J, Morita A . Mechanisms of ultraviolet (UV) B and UVA phototherapy. J Investig Dermatol Symp Proc. 1999; 4(1):70-2. DOI: 10.1038/sj.jidsp.5640185. View

Olsen E, Vonderheid E, Pimpinelli N, Willemze R, Kim Y, Knobler R . 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.... Blood. 2007; 110(6):1713-22. DOI: 10.1182/blood-2007-03-055749. View

Prince H, Whittaker S, Hoppe R . How I treat mycosis fungoides and Sézary syndrome. Blood. 2009; 114(20):4337-53. DOI: 10.1182/blood-2009-07-202895. View

10.

Pimpinelli N, Olsen E, Santucci M, Vonderheid E, Haeffner A, Stevens S . Defining early mycosis fungoides. J Am Acad Dermatol. 2005; 53(6):1053-63. DOI: 10.1016/j.jaad.2005.08.057. View

11.

Ko J, Seong J, Suh K, Kim S . Pityriasis lichenoides-like mycosis fungoides in children. Br J Dermatol. 2000; 142(2):347-52. DOI: 10.1046/j.1365-2133.2000.03307.x. View

12.

Wang S, Hsiao C, Hsiao P, Chu C . Adult pityriasis lichenoides-like mycosis fungoides with high density of CD8-positive T-lymphocytic infiltration. J Eur Acad Dermatol Venereol. 2007; 21(3):401-2. DOI: 10.1111/j.1468-3083.2006.01878.x. View

13.

Suh K, Kang J, Baek J, Kim T, Lee J, Jeon Y . Efficacy of ultraviolet A1 phototherapy in recalcitrant skin diseases. Ann Dermatol. 2010; 22(1):1-8. PMC: 2883385. DOI: 10.5021/ad.2010.22.1.1. View

14.

Jang M, Baek J, Park J, Kang D, Kang J, Suh K . Narrowband ultraviolet B phototherapy of early stage mycosis fungoides in korean patients. Ann Dermatol. 2011; 23(4):474-80. PMC: 3229941. DOI: 10.5021/ad.2011.23.4.474. View

15.

Vonderheid E, Kadin M . Papular mycosis fungoides: a variant of mycosis fungoides or lymphomatoid papulosis?. J Am Acad Dermatol. 2006; 55(1):177-80. DOI: 10.1016/j.jaad.2006.01.030. View

16.

Ahn C, Alsayyah A, Sangueza O . Mycosis fungoides: an updated review of clinicopathologic variants. Am J Dermatopathol. 2014; 36(12):933-48. DOI: 10.1097/DAD.0000000000000207. View

17.

Massone C, Kodama K, Kerl H, Cerroni L . Histopathologic features of early (patch) lesions of mycosis fungoides: a morphologic study on 745 biopsy specimens from 427 patients. Am J Surg Pathol. 2005; 29(4):550-60. DOI: 10.1097/01.pas.0000153121.57515.c6. View