Background: Ten-year survival rates in mycosis fungoides (MF) broadly varies, however, there is no standardized prognostic index available. This is presumably due to low prevalence, heterogeneity, and diagnostic challenges in MF. Recent studies have focused on identifying objective prognostic indices by using different parameters for survival determinants. The Cutaneous Lymphoma International Prognostic Index (CLIPI) and the Prospective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) represent prototypical studies that identify prognostic factors, seeking to improve management and outcomes in early-stage MF. Detecting these factors and stratifying MF patients according to their disease progression risk may help to manage these patients more efficiently.Aims: Review the current literature to determine the risk factors determining prognosis in MF.Methodology: A Comprehensive literature search was performed using electronic online databases "PubMed" and "Google Scholar" using key words 'prognostic factor', 'prognostic indicator', 'mycosis fungoides', 'Sezary syndrome', 'Skin Lymphoma', 'Cutaneous Lymphoma'. Articles published in English language were considered for the review. Results: The strongest prognostic factor in MF patients is the stage of the disease. T stage and the presence of extracutaneous disease are the most important factors for survival. Other factors that are associated with worse prognosis are male gender, age >60, presence of plaques, folliculotropism, eosinophilia and lymph node stage above N1/Nx. Elevated LDH was associated with later tumor stages and large cell phenotype at diagnosis had a better prognosis. KIR3DL2 was associated with malignant transformation. Conclusion: The PROCLIPI study has assessed risk factors collected in MF patients from different countries and across different ethnicities following a rigorous clinicopathologic process. The findings presented here illustrated that disease prognosis in How to cite this article: Farabi B, Seminario-Vidal L, Jamgochian M, et al. Updated review on prognostic factors in mycosis fungoides and new skin lymphoma trials.
We investigated a method for automatic skin tissue characterization based on optical coherence tomography (OCT) imaging. We developed a manually scanned single fiber OCT instrument to perform in vivo skin imaging and tumor boundary assessment. The goal is to achieve more accurate tissue excision in Mohs micrographic surgery (MMS) and reduce the time required for MMS. The focus of this study was to develop a novel machine learning classification method to automatically identify abnormal skin tissues through one-class classification. We trained a deep convolutional neural network (CNN) with a U-Net architecture for automatic skin segmentation, used the pre-trained U-Net as a feature extractor, and trained one-class support vector machine (SVM) classifiers to detect abnormal tissues. The novelty of this study is the use of a neural network as a feature extractor and the use of a one-class SVM for abnormal tissue detection. Our approach eliminated the need to engineer the features for classification and eliminated the need to train the classifier with data obtained from abnormal tissues. To validate the effectiveness of the one-class classification method, we assessed the performance of our algorithm using computer synthesized data, and experimental data. We also performed a pilot study on a patient with skin cancer.
these patients. Therefore, inhibition of the Th2 response may theoretically combat immunosuppression-induced PTAA. Dupilumab is a human monoclonal antibody that suppresses Th2 mediated inflammation by selectively blocking IL-4 and IL-13 cytokines. 5 Dupilumab was approved in 2019 for use in 12 to 18 year old patients and was being investigated as an add on maintenance treatment for children 6 to 11 years old prior to recent approval in that age group. 6,7 There are some case reports of dupilumab being used with success in heart transplant recipients older than 18 years of age, but literature pertaining to its use in adolescent solid organ transplant recipients is sparse. 8,9 Previous studies have indicated that Dupilumab is well tolerated in adolescents with moderate to severe atopic dermatitis, with most common side effects being conjunctivitis, facial redness, injection site reactions, and reactivation of oral herpes. 7,10 3 | CONCLUSION Patients taking systemic immunosuppressive therapies can experience new atopic dermatitis or exacerbation of preexisting AD due to the imbalance between the Th2 and Th2 immune responses. In pediatric solid organ transplant patients with AD who have not seen improvement with topical therapies, there is evidence that dupilumab is both safe and effective.
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