Multiple skin cancers in patients with mycosis fungoides after long-term ultraviolet phototherapy

Abstract

Phototherapy is a useful noninvasive therapy, but it can induce cutaneous malignant tumours, including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). We report on a 79-year-old man who had long-standing mycosis fungoides for 40 years, which had been treated with psoralen ultraviolet A therapy for 37 years at a dose of approximately 5000 J/cm . Approximately 6 years before presentation, numerous types of cutaneous malignancies, including actinic keratosis, BCC and SCC, had begun to develop all over the patient's body. We hypothesized that he was experiencing a pathogenesis similar to patients with xeroderma pigmentosum (XP), and we therefore assessed his DNA repair capacity. Based on these investigations, the patient was eventually diagnosed as non-XP, even though we detected that his DNA repair capacity was slightly lower than that of normal controls, which may have led to the skin cancers. We speculate that multiple skin malignancies can be induced by long-term phototherapy in patients with slightly impaired DNA repair capacity.

Risk of skin cancers in mycosis fungoides patients receiving PUVA therapy: A real‐life experience from a single tertiary center

“…The presence of PUVA lentigines was proposed as a warning sign for the development of skin cancer regardless of the number of PUVA sessions 17 . Multiple skin cancers were observed in some of the patients in our cohort, as previously reported in other studies 12,13,18 . A subset of MF patients may be more susceptible than others to cutaneous malignancies due to shared genes that increase cancer susceptibility.…”

“…17 Multiple skin cancers were observed in some of the patients in our cohort, as previously reported in other studies. 12,13,18 A subset of MF patients may be more susceptible than others to cutaneous malignancies due to shared genes that increase cancer susceptibility. Further studies are needed to elucidate potential genetic risk factors to be able to screen patients with higher risk for UV damage for prevention.…”

Μορφολογική Και Ανοσοϊστοχημική Διερεύνηση Βιοψιών Δέρματος Σε Ασθενείς Με Σπογγοειδή Μυκητίαση

“…Σε αυτούς τους ασθενείς, η MF δύναται να αντιπροσωπεύει είτε την πρωτογενή είτε την επακόλουθη νεοπλασία. Επιπλέον, έχει υποστηριχθεί ότι πολλαπλές δερματικές κακοήθειες, όπως καρκίνωμα πλακώδους επιθηλίου και βασικοκυτταρικό καρκίνωμα, δύνανται να προκληθούν από μακροχρόνια φωτοθεραπεία σε ασθενείς με ελαφρώς μειωμένη ικανότητα επιδιόρθωσης DNA [Imafuku, 2017]. Ορισμένες διηθήσεις MF δύνανται να παρατηρηθούν σε καλοήθεις και κακοήθεις δερματικές εξεργασίες, όπως κακόηθες μελάνωμα [Pielop, 2003], μελανοκυτταρικούς σπίλους [Brazzelli, 2012], ακτινική κερατίαση και σμηγματορροϊκή κερατίαση [Lebas, 2017], μεταξύ άλλων.…”