Mycosis Fungoides Diagnosed with an Initial Sign Resembling Benign Dermatosis on the Upper Eyelids

Lim, Eun Hwa; Lim, Seul Ki; Im, Myung; Seo, Young‐Joon; Lee, Jeung Hoon; Lee, Young

doi:10.5021/ad.2015.27.4.469

Cited by 7 publications

(6 citation statements)

References 4 publications

(8 reference statements)

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“…With such a low prevalence of periorbital involvement in MF, it is important to consider other conditions, such as contact dermatitis, eczema, atopic dermatitis, seborrheic dermatitis, discoid lupus, or atypical blepharitis as a differential diagnosis. All of these entities may mimic MF of the eyelid (8)(9)(10). Four patients of our cohort had a concomitant diagnosis of blepharitis with positive skin cultures, indicating that both conditions can occur in the same patient, which might delay a correct diagnosis.…”

Section: Discussionmentioning

confidence: 89%

Periorbital Involvement in Early Stage Mycosis Fungoides

et al. 2017

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Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphomas (CTCL) and accounts for approximately 50% of all CTCL (1, 2). Classically, it presents with erythematous patches on sun-protected areas 2-10 years before confirmed on skin biopsy (3). Approximately 10% of patients initially presenting with patches will subsequently progress to advanced stages of disease (4). Since its first description, MF continues to evolve with discovering of new variants (2). Periorbital involvement is a rare finding in MF and is usually associated with advanced stages of disease. In 1892, Besnier & Hallopeau reported the first patient with periorbital involvement, and extensive and ultimately, fatal disease (5). While the majority of cases describe patients with advanced stages, to date only few reports of isolated periorbital involvement, in early stage MF have been published (6-11). Herein, we report the clinical, epidemiological and histopathological presentation of 7 patients with biopsy proven early stage MF and periorbital lesions. PATIENTS AND METHODS We conducted a retrospective study of patients seen with periorbital MF lesions, at the CTCL clinic at the MD Anderson Cancer Center, Houston Texas. The study protocol was approved by the institutional review board (#PA16-0091). Additional informed consent was obtained from all individual participants for whom identifying information is included in this article. Electronic medical records and paper-based flow charts were screened for patients with periorbital involvement in MF. Clinical and histopathological data were re-evaluated. Diagnosis and staging of MF were made by a CTCL expert (M.D), according to the modified International Society of Cutaneous Lymphomas/European Organization for Research and Treatment of Cancer revisions of the TNMB Classification of MF and Sézary syndrome (1). All analyses were conducted using SPSS version 22.0 (IBM Corporation, Armonk, NY, USA). Continuous data are expressed as mean ± standard deviation (SD) and median (range), as appropriate. Basic summary statistics were used to describe demographic data, treatment modalities, and response.

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Section: Discussionmentioning

confidence: 89%

Periorbital Involvement in Early Stage Mycosis Fungoides

et al. 2017

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“…Clinically, MF was mimicked by other biopsy-proven inflammatory diseases such as eczema, psoriasis, nonspecific dermatitis, lichen, lupus, pseudolymphoma, parapsoriasis, and toxidermia. This was confirmed by other studies that researched the overlapping histopathologic features of MF and psoriasis ( Doukaki et al, 2009 , Jinno et al, 2015 ), lichen ( Citarella et al, 2003 , Magro et al, 1997 , Suchak et al, 2010 ), eczema ( Ackerman et al, 1974 , Ecker and Winkelmann, 1981 , LeBoit and Epstein, 1990 , Miyagaki and Sugaya, 2011 , Orbaneja et al, 1976 , Reddy and Bhawan, 2007 , Solomon et al, 2016 , White, 1990 ), pseudolymphoma ( Choi et al, 2003 , Rijlaarsdam et al, 1991 , Rijlaarsdam et al, 1992 ), cutaneous drug reactions ( Sarantopoulos et al, 2013 ), parapsoriasis ( Goldberg, 2012 ), chronic and nonspecific dermatitis ( Elmer and George, 1999 ), and others dermatosis ( Deen et al, 2015 , Fujimoto et al, 2015 , Kazlouskaya et al, 2015 , Lim et al, 2015 , Rodriguez-Acosta et al, 2013 , Yalcin et al, 2014 ).…”

Section: Discussionmentioning

confidence: 99%

Defining the mimics and clinico-histological diagnosis criteria for mycosis fungoides to minimize misdiagnosis

Kelati

Gallouj

Tahiri

et al. 2017

International Journal of Women's Dermatology

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BackgroundMycosis fungoides (MF) is a significant diagnostic challenge; it has various differential diagnosis especially at an early stage. Our aim was to describe mimics of MF clinically and histologically, and to define significant diagnostic criteria of the disease.MethodsThis was a retro-prospective cohort of 370 patients in whom the diagnosis of MF was suspected clinically.ResultsMF was histologically confirmed in 15.4% of cases and rejected in 84.5%. Other identified histologically diagnosis were eczema, psoriasis; nonspecific dermatitis, lichen, lupus; pseudolymphoma, parapsoriasis and toxidermia. 4 patients with palmoplantar MF were wrongly treated as eczema, and 10 patients with psoriasiform MF were initially treated as psoriasis. We also described the clinical, histological and immunohistochemistry diagnostic criteria for distinguishing MF from benign dermatosis.ConclusionsMisdiagnosis of MF was a real problem for this study, because it shared common clinical and histological characteristics with other inflammatory diseases like eczema and psoriasis. Therefore, defining significant clinico-histological diagnosis criteria of MF would be of great help and would increase the accuracy of the diagnosis.

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“…Eyelid lesions of MF are usually diagnosed clinically and biopsy may not be required from this localization, as patients with eyelid involvement have mostly been previously diagnosed with MF from lesions of other areas 3,10,15 . However, isolated lesions of the eyelid as an initial manifestation or recurrence sign of MF have also been described 18–20 . The reported clinical presentation of eyelid involvement of MF is quite variable 3,4,10,15–17 .…”

Section: Mycosis Fungoidesmentioning

confidence: 99%

“…In a report evaluating eight MF patients without stating the subtype and stage of MF blepharitis (50%), thickened eyelids (37.5%) and flaking (25%) were the most prevalent ophthalmologic findings (Table 1). 21 Erythematous scaly (dermatitis‐like) patches or plaques representing most commonly encountered lesions in different types of MF (Figure 1d) must primarily be differentiated from eczematous dermatological conditions, seborrheic dermatitis, psoriasis and heliotrope rash of dermatomyositis in clinical practice 15,18,19 . The eyelid involvement has been reported in different periods during the course of MF.…”

Section: Mycosis Fungoidesmentioning

confidence: 99%

“…3,10,15 However, isolated lesions of the eyelid as an initial manifestation or recurrence sign of MF have also been described. [18][19][20] The reported clinical presentation of eyelid involvement of MF is quite variable. 3,4,10,[15][16][17] In most reports detailed information of patients regarding stage and MF subtypes were not mentioned.…”

Section: Mycosis Fungoidesmentioning

confidence: 99%

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Eyelid involvement of primary cutaneous lymphomas: A clinical perspective

Baykal

Atci

2023

Aust J Dermatology

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Eyelids may be affected in systemic, ocular adnexal and primary cutaneous lymphomas (PCLs). The frequency of eyelid involvement in PCLs is still not well known and it is not a predilection site for any type. While primary cutaneous T‐cell lymphomas (CTCLs) are more commonly seen than primary cutaneous B‐cell lymphomas (CBCLs), especially mycosis fungoides (MF) as by far the most frequent type, B cell lymphomas are reported to be the commonest type in eyelid localization on the contrary. PCLs may be located on the eyelids, as the sole manifestation or in association with the involvement of other parts of the eye and elsewhere of the body. MF may present with a rich spectrum of clinical features on the eyelids mostly seen in folliculotropic subtype and advanced‐stage disease. Erythematous scaly patches or plaques representing the most commonly encountered eyelid MF lesions may mimic many other dermatological conditions. Diffuse thickening, oedema, poikilodermic changes, atrophy and wrinkling are other suggestive findings of eyelid MF. Milia‐like papules, madarosis and ectropion are also seen in the folliculotropic variant of MF, as ectropion is more typical for Sezary syndrome. Eyelids are also a typical location for tumoural MF which has been suggested as a poor prognostic indicator in MF. Papulonodular lesions, large tumours, ulceration, diffuse infiltration, oedema and subcutaneous atrophy on the eyelids may also be seen in other types of PCLs. Keep in mind, the rich clinical spectrum of PCLs on the eyelids may be crucial in early diagnosis in this special localization.

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Mycosis Fungoides Diagnosed with an Initial Sign Resembling Benign Dermatosis on the Upper Eyelids

Cited by 7 publications

References 4 publications

Periorbital Involvement in Early Stage Mycosis Fungoides

Periorbital Involvement in Early Stage Mycosis Fungoides

Defining the mimics and clinico-histological diagnosis criteria for mycosis fungoides to minimize misdiagnosis

Eyelid involvement of primary cutaneous lymphomas: A clinical perspective

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