Hyperpigmentation as a peculiar presentation of mycosis fungoides

Abstract

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.

Hyperpigmented lichenoid mycosis fungoides as a new variant: clinical and histopathological evaluation

“…Similar to the previously mentioned reports of hyperpigmented MF [5][6][7][8][9][10][11][12][13][14], all of the 12 patients, in the present study, were dark-skinned with Fitzpatrick skin type III and IV.…”

“…Therefore, clinicopathologic correlation is mandatory to reach a proper diagnosis in the early stages of the disease [4]. Up to the best of our knowledge, there have been a total of nine published reports since 1996, those reports are of 16 patients (9 males and 7 females) in which MF was presented entirely or predominantly by hyperpigmented patches or plaques [5][6][7][8][9][10][11][12][13][14]. Their ages ranged from 19-69 yr with a mean age of 44 years (Table 1).…”

Micosis fungoide hiperpigmentada de cara y pliegues en adultos: estudio prospectivo de una nueva variedad clínica

“…12,18 Las lesiones hiperpigmentadas en nuestra cohorte estuvieron presentes exclusivamente en pacientes con fototipos cutáneos altos (> III), similar a los casos publicados con anterioridad. [8][9][10][11][12][13][14][15] En 12 pacientes (44%), las lesiones se ubicaron en cabeza, cuello y tronco.…”

“…En contraste con los casos reportados de MF variedad hiperpigmentada, en los que las lesiones se han descrito como manchas o placas hiperpigmentadas con escama en su superficie, ubicadas principalmente en tronco y extremidades, [8][9][10][11][12][13][14][15] las lesiones en el grupo de pacientes estudiados en este centro se manifestaron como manchas hiperpigmentadas de color marrón o marrón violáceo, de límites difusos, localizadas en cara, cuello y zona V del escote.…”

“…6 La MF hiperpigmentada es una variante clínica poco frecuente que ha sido comunicada como reporte y serie de casos. [8][9][10][11][12][13][14][15] De forma similar a la variedad hipopigmentada, está subdiagnosticada en pacientes con fototipos cutáneos altos. Clínicamente se caracteriza por la presencia de manchas o placas hiperpigmentadas, de bordes más o menos definidos, con varios grados de atrofia y escama.…”