Loss of melanocytes in hypopigmented mycosis fungoides: a study of 18 patients

Furlan, Felipe Favoretto; Pereira, Bruna A.; Silva, Luiz F. da; Sanches, José Antônio

doi:10.1111/cup.12262

Cited by 22 publications

(22 citation statements)

References 21 publications

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“…In HMF, the CD8+T-cells participate in the Th1 immune response, and thus may prevent evolution to aggressive stages, even though the cells are malignant. In cases of patients with HMF with a CD4+neoplastic infiltrate, CD8+T cells may also have an important immunoregulatory action 18. Moreover, CD8+phenotype predominance is consistent with the hypothesis that hypopigmentation results from lymphocyte cytotoxicity against melanocytes and melanogenesis, as observed in vitiligo pathogenesis 8 18.…”

Section: Discussionsupporting

confidence: 71%

“…In cases of patients with HMF with a CD4+neoplastic infiltrate, CD8+T cells may also have an important immunoregulatory action 18. Moreover, CD8+phenotype predominance is consistent with the hypothesis that hypopigmentation results from lymphocyte cytotoxicity against melanocytes and melanogenesis, as observed in vitiligo pathogenesis 8 18. Therefore, hypopigmentation might represent the clinical translation of the protective immune response, and a marker of good prognosis.…”

Section: Discussionsupporting

confidence: 64%

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Childhood hypopigmented mycosis fungoides: a commonly delayed diagnosis

2014

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Primary cutaneous lymphomas (PCLs) are exceedingly rare in children and adolescents, with mycosis fungoides (MF) being the most frequent PCL diagnosed in childhood. There are numerous unusual clinical variants of MF, including the hypopigmented type form (HMF). HMF is exceptional overall, but comparatively common among children. We present an 8-year-old boy with a 3-year history of progressive, generalised, scaly, hypopigmented round patches and few erythematous papules. He was first diagnosed with pityriasis alba (PA), and moisturisers were prescribed with no improvement. Skin biopsy showed typical features of MF, and the patient was successfully treated with narrowband ultraviolet B. HMF may simulate atopic dermatitis, PA, pityriasis lichenoides, tinea versicolour, vitiligo, postinflammatory hypopigmentation or leprosy. Therefore, persistent and unusual hypopigmented lesions should be biopsied to rule out this rare variant of MF.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionsupporting

confidence: 64%

Childhood hypopigmented mycosis fungoides: a commonly delayed diagnosis

2014

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“…The T suppressor lymphocytes might play an immunoregulatory role in the neoplastic process, preventing disease progression and keeping patients on early stages, as described by us. Furthermore, cytotoxic CD8+ cells could present an inhibitory activity on melanocytes, causing melanocyte degeneration, abnormal melanogenesis, melanosome transfer and resulting hypopigmentation [12]. …”

Section: Discussionmentioning

confidence: 99%

Hypopigmented Mycosis Fungoides versus Mycosis Fungoides with Concomitant Hypopigmented Lesions: Same Disease or Different Variants of Mycosis Fungoides?

et al. 2014

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Background: Hypopigmented mycosis fungoides (HMF) is a rare subtype of mycosis fungoides (MF). We compared patients with exclusive hypopigmented lesions with a group of MF patients with concomitant different lesions. Methods: 20 patients with HMF only and 14 patients with hypopigmented lesions concomitant with other types of lesions (mixed MF, MMF) were selected. Clinical-epidemiological analysis as well as histological and immunohistochemical studies were performed. Results: HMF and MMF preserve some similarities, like predilection for dark-skinned persons and slow progression, but they also present differences: the exclusive variant is associated with early onset and a clear CD8+ immunophenotype, whereas MMF patients tend to present a predominance of CD4+ cell infiltrates. Histological analysis revealed similar findings; relapsing courses were common. Conclusion: Whether patients are suffering from exclusive HMF or MMF, the presence of hypopigmented lesions can be considered a marker of good prognosis in MF, since both groups presented similar data, such as staging and disease duration.

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“…The main differential diagnosis is pityriasis alba, which typically affects the face and the lateral parts of the arms. In hypopigmented MF lesions, the prevalence of CD8+neoplastic lymphocytes (due to their cytotoxic action) would lead to dysfunction of the melanocytes, altering melanin production and distribution and culminating in the formation of clinically hypochromic lesions 40 . It is an indolent disease, and treatment with topical corticosteroids, topical nitrogen mustard, or phototherapy (either UVBnb or PUVA) can induce clinical remission 41 .…”

Section: Hypopigmented Mfmentioning

confidence: 99%

Cutaneous lymphomas: A review

Miyashiro¹,

Sanches²

2015

Cumhuriyet Med J

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SUMMARYSkin may be affected by non-Hodgkin lymphomas, and it is the second most frequently involved extranodal organ, after the gastrointestinal tract. Cutaneous lymphomas may originate from T, B, or NK lymphocytes. Diagnosis is difficult, and knowledge of these diseases is important to ensure their detection and adequate treatment and follow-up. Clinical picture is heterogeneous, and histology is essential to confirm the diagnosis. The classification is given by the correlation between clinical findings, histology and immunophenotyping. Therapeutic options include skin-directed therapies, immunomodulatory or low-dose immunosuppressive drugs. Rare cases of aggressive disease require systemic multidrug chemotherapy. The purpose of this review is to describe the ontogeny of T, B and NK lymphocytes, and to detail the most accepted classification of cutaneous lymphomas, proposed by the World Health Organisation and European Organisation for Research and Treatment of Cancer. Treatment of cutaneous lymphomas will be briefly discussed.

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Loss of melanocytes in hypopigmented mycosis fungoides: a study of 18 patients

Cited by 22 publications

References 21 publications

Childhood hypopigmented mycosis fungoides: a commonly delayed diagnosis

Childhood hypopigmented mycosis fungoides: a commonly delayed diagnosis

Hypopigmented Mycosis Fungoides versus Mycosis Fungoides with Concomitant Hypopigmented Lesions: Same Disease or Different Variants of Mycosis Fungoides?

Cutaneous lymphomas: A review

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