Comorbidities in Mycosis Fungoides and Racial Differences in Co-Existent Lymphomatoid Papulosis: A Cross-Sectional Study of 580 Patients in an Urban Tertiary Care Center

Abstract

Background: Mycosis fungoides (MF) is a cutaneous T-cell lymphoma. Previous reports have suggested MF is associated with inflammatory conditions such as psoriasis, increased cardiovascular risk factors as well as secondary neoplasms. Methods: A cross-sectional study of MF patients seen from 2013 to 2019 was performed. Comorbidities were selected based on the 2015 Medicare report highlighting the most common chronic medical illnesses in the United States. Lifetime comorbidity occurrence in patients with MF were compared with that in patients with atopic dermatitis, psoriasis and patients without MF. Additional analyses were performed with patients sub-stratified by race. Results: Compared to control groups, MF was strongly associated with lymphomatoid papulosis and Hodgkin’s disease, but not significantly associated with lung, breast or colon cancer. Interestingly, the association with lymphomatoid papulosis was observed in Caucasians (CI 1062-4338; p < 0.001) and not African Americans (p = 0.9). Patients with MF had a greater association with congestive heart failure, hypertension (HT) and hyperlipidemia (HLD) compared with the general population. However, they were significantly less likely to have HT and HLD when compared with psoriasis patients (HT CI: 0.6–0.9; p < 0.001, and HLD CI: 0.05–0.07; p < 0.001). MF patients were also significantly less likely to have concomitant vitamin D deficiency compared with atopic dermatitis (AD) and psoriasis (p < 0.001). Conclusions: Our results suggest that the association of MF with lymphomatoid papulosis varies by race. Compared to the general population, hypertension and hyperlipidemia were positively associated with MF, however, these were significantly less likely on comparison to psoriasis. Unlike previously described, vitamin D deficiency was found to be significantly less in patients with MF.

Evaluation of Associated Lymphomas and Their Risk Factors in Patients with Lymphomatoid Papulosis: A Retrospective Single-Center Study from Turkey

“…A total of 692 patients were diagnosed with MF during the same 21 years in our clinic (unpublished data), and the ratio of association of LyP in this MF group was 2.7% (n=19) ( Figure 3 ). In a recently reported large series of MF patients (n=580), the rate for association of LyP was found to be 1.9% [ 19 ]. Interestingly, in the same study, a significant association of LyP among Caucasian MF patients (3%) was reported when compared to African American MF patients (0%) [ 19 ].…”

“…LyP has an almost excellent prognosis with a 10-year survival rate of up to 100%, with a variable clinical course ranging from a few to frequent relapses [ 5 ]. However, this good prognosis may change in patients with associated cutaneous and systemic lymphomas [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Possible risk factors for secondary lymphomas and the frequency of this association remain unclear [ 7 , 9 , 10 , 11 , 15 , 16 , 17 , 18 ].…”

Emerging Research in Chronic Pruritus: From Bedside to Bench and Back Again

“…This study found that MF was strongly associated with lymphomatoid papulosis, Hodgkin's disease, congestive heart failure, hypertension, and hyperlipidemia compared with healthy controls [11]. Of note, the association between MF and lymphomatoid papulosis was seen in Caucasian and not African American patients [11]. The study provides valuable epidemiologic information on MF that can be used by clinicians managing this condition [11].…”

“…Given the chronic nature of this disease, comorbid conditions can significantly add to patient burden. Therefore, Kaul et al performed a cross sectional study to evaluate 580 adult patients with diagnosed MF, to identify the common illnesses associated with MF and any racial differences in comorbid disease [11]. This study found that MF was strongly associated with lymphomatoid papulosis, Hodgkin's disease, congestive heart failure, hypertension, and hyperlipidemia compared with healthy controls [11].…”

“…Therefore, Kaul et al performed a cross sectional study to evaluate 580 adult patients with diagnosed MF, to identify the common illnesses associated with MF and any racial differences in comorbid disease [11]. This study found that MF was strongly associated with lymphomatoid papulosis, Hodgkin's disease, congestive heart failure, hypertension, and hyperlipidemia compared with healthy controls [11]. Of note, the association between MF and lymphomatoid papulosis was seen in Caucasian and not African American patients [11].…”