Hyperpigmented mycosis fungoides is an extremely rare subtype of mycosis
fungoides. It presents as multiple pigmented macules and patches without
poikilodermatous changes and characterized by a CD8+ phenotype on
immunohistochemistry. This report describes a typical case of hyperpigmented
mycosis fungoides in a 62-year-old woman, who presented with a 7-year history of
multiple hyperpigmented macules and patches on the trunk and right leg with
progression over this half a year. Histology and immunohistochemical staining of
skin samples confirmed the diagnosis of mycosis fungoides. She received psoralen
plus ultraviolet A (PUVA) therapy. After an 8-week treatment, the erythematous
changes cleared without recurrence during a 6-month follow-up period. An
intractable hyperpigmented patch should raise the clinical suspicion of mycosis
fungoides with sequential skin biopsy.
Context: Unusual cataracts (flecks) have been reported to occur at very low levels of trinitrotoluene exposure, but prevalence estimates vary widely. Cataracts have not been reported among workers in the United States exposed to organic nitrate explosives.Objectives: To determine the prevalence of unusual cataracts in a population of workers in the United States exposed to organic nitrate explosives, to determine whether associations exist with reported cataract risk factors, and to determine if other eye effects (eg, retinal hemorrhage) are associated with exposure.
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