498 Nitrogen mustard-induced inflammation triggers lymphomatoid papulosis in patients with Mycosis Fungoides

Abstract

Basal cell carcinoma (BCC) environment consists of stromal and inflammatory cells which produce variety of cytokines, chemokines and growth factors that may affect the tumor behavior. One of the cytokines suggested to be involved in the pathogenesis of BCC is IL-6the upstream element of IL-6/JAK/STAT3 pathway. In the present study rs1800795 (-174 G/C) IL-6 gene polymorphism and STAT3 rs2293152 (intron 11, C/G) and rs4796793 (e1697, C/G) polymorphisms were assessed in relation to the BCC risk and clinical course. Additionally, IL-6 serum level was assessed in relation to IL-6 genotype and clinical variables. The study included 254 unrelated BCC patients (mean age 70.39AE11.43) and 198 healthy, unrelated age-and sex-matched volunteers. We have found that the presence of C allele in rs1800795 IL-6 gene polymorphism was associated with increased risk of BCC (aOR: 1.86; 95% CI¼1.22-2.84; p¼0.004). The presence of CC genotype in STAT3 rs2293152 polymorphism was associated with increased BCC risk in recessive model analysis (aOR¼3.94; 95% CI: 1.59-9.77; p¼0.003). In contrast, the presence of GC genotype in overdominant model was associated with decreased risk of BCC (aOR¼0.24; 95% CI:0.12-0.49; p<0.0001). The presence of C allele in STAT3 rs2293152 polymorphism was associated with increased risk of BCC (aOR: 1.31; 95% CI:1.01-1.69; p¼0.04). The presence of GG genotype in STAT3 rs4796793 polymorphism was associated with increased BCC risk in recessive model analysis (aOR¼3.66; 95%

Topical chlormethine gel in the treatment of mycosis fungoides: A single‐center real‐life experience and systematic review of the literature

“…Concomitant therapies were not used by Lessin et al 10 and Talpur et al, 16 while Gilmore et al 18 and Trager et al 21 did not report this data.…”

“…17,20 Risk of non-melanoma skin cancer in CG treated areas has been debated with conflicting conclusions. 10,21,22 The short observation period of our casuistic do not let to collect data on CG skin carcinogenesis.…”

“…10,20,25 Regarding therapies used previously, topical steroid is the most prescribed (72.7%), followed by systemic retinoid (45.5%), and Garcia-Saleem et al 24 and Geskin et al 22 applied only topical steroid, while in two studies topical chlormethine was used as first choice in small percentage of patients (11.8%-20.0%). 19,21 Therapy most prescribed in association with chlormethine is the topical steroid (63.6%).…”

“…However, clinical response data of each group are not available.A real-life single-center study conducted by Prag Naveh et al20 accurately detailed the most common CG side effects: 36% of the sample developed ICD and ACD (Allergic Contact Dermatitis), 14% hyperpigmentation, 9% pruritus and 9% unmasking effect (clinical appearance of new early-stage lesions not previously observed in the application area within the first weeks of treatment). The clinical response rate was around 50% and adverse events were controlled decreasing the CG application rate or associating topical steroids.A transformation to lymphomatoid papulosis (LyP) after 2-8 months (average 5.6 months) of CG treatment was reported in 10 patients by Trager et al21 They were affected by an early-stage (IA-IIB) of MF and an association between inflammatory stimuli and development of LyP was suggested. Geskin et al22 performed a narrative review considering also other topical preparations of chlormethine (aqueous, ointment and gel 0.04%) not yet available in the market.…”