CD8⁺ cytotoxic mycosis fungoides: a retrospective analysis of clinical features and follow‐up results of 29 patients

Abstract

Background and objective Less than 5% of cases of mycosis fungoides (MF) present with a cytotoxic/suppressor CD8 + phenotype. This study aimed to evaluate the clinical characteristics, treatment modalities, and clinical course in CD8 + MF patients.Methods In a retrospective analysis of 353 MF patients in a referral center at Ankara University, Turkey, 29 patients that were diagnosed with CD8 + MF were included in the study.Results CD8 + MF cases constituted 8.2% of all MF patients. The age at the time of diagnosis ranged between 6 and 81 years with a median value of 46 years. The female-tomale ratio was 1.41. Patients presented with erythematous scaly (69%), hyperpigmented (58.6%), poikilodermic (17.2%), and hypopigmented (17.2 %) patches/plaques. The most common sites of involvement were the trunk and lower extremities. The most common comorbidity was hypertension (24.1%, n: 7) with 13 patients (44.8%) having a history of at least one autoimmune disease. At the time of diagnosis, 93.2% of the patients had earlystage disease, and 6.8% of the patients had advanced stage. The mean follow-up period was 6.68 AE 6.04 years (range 1-28 years). Most of the patients were treated with skindirected therapies. Complete remission was achieved in 17 (58.6%) patients, eight (27.6%) patients had partial remission, and four (13.8%) patients had stable disease.Conclusions We concluded that CD8 + MF is associated with an indolent course and in most patients, skin-directed therapies were found to be efficient to control the disease.

Hyperpigmented Mycosis Fungoides Masquerading as Longstanding Lichen Planus Pigmentosus: A Diagnostic Pitfall

“…It is essential to differentiate MF from other epidermotropic lymphomas, such as gamma–delta T-cell lymphoma and primary cutaneous CD8 + aggressive epidermotropic cytotoxic T-cell lymphoma. 36 These variants can be distinguished based on their unique immunoprofiles and clinicopathologic correlations. Other benign conditions that can mimic MF include actinic reticuloid and lichen planus-like keratosis.…”

Dupilumab-Associated Mycosis Fungoides with a CD8+ Immunophenotype

“…Massone et al evaluated 73 specimens from 68 patients with early-stage disease at diagnosis (either stage Ia or Ib), and suggested that at early stages, CD8+ MF does not behave differently to CD4+ MF, and does not necessarily have a worse prognosis [ 24 ]. However, another study highlighted the fact that CD8+ MF is not a single entity, but rather a ‘mixed-bag’ of presentations, with some having more indolent courses similar to the typical CD4+ MF, such as those with hypopigmented patches often found in the younger population, and others demonstrating a more aggressive course [ 25 , 26 ]. Other studies comparing CD8+- and CD4+-predominant MF cohorts, suggest that CD8+ MF has a more indolent course, and suggest a treatment approach limited to skin-directed therapies and observation, for most patients [ 26 , 27 ].…”

Mycosis fungoides in an 11 year-old child: a case report

“…С и с т е м н а я т е р а п и я ГКС на очень ранних стадиях заболевания дают в среднем почти 50% общего ответа, возможно их сочетание с топическими ретиноидами [8 , 36,37]. Кроме того, при необходимости системного лечения агрессивных форм заболевания исполь зуют такие препараты, как липосомальный доксорубицин, брентуксимаб ведотин, ифосфамид, этопозид, гемцитабин.…”