Mycosis fungoides in the era of antitumour necrosis factor‐α treatments

Nikolaou, Vasiliki; Papadavid, Evangelia; Economidi, Afroditi; Marinos, Leonidas; Moustou, E; Karampidou, K.; Papadaki, Theodora; Stratigos, Alexandros; Antoniou, Christina

doi:10.1111/bjd.13705

Cited by 24 publications

(36 citation statements)

References 15 publications

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“…The histopathologic characteristics of early MF may differ from person to person, between different biopsy locations in the same patientand may be altered by the use of topical steroids or immunosuppressive therapy . Anti‐tumor necrosis factor alpha (TNF alpha) therapy for presumed benign inflammatory dermatoses such as psoriasis or dermatitis has been linked to advanced stages at diagnosis of cutaneous lymphoma and lymphoma progression …”

Section: Discussionmentioning

confidence: 99%

“…25 Anti-tumor necrosis factor alpha (TNF alpha) therapy for presumed benign inflammatory dermatoses such as psoriasis or dermatitis has been linked to advanced stages at diagnosis of cutaneous lymphoma and lymphoma progression. 26,27 Diagnostic discordance in early MF has been noted in approximately 20% of cases. 9 This may lead to vague, non-specific and inconclusive pathology interpretations of early stage lesions of MF 28 39 ; however, access to testing is limited.…”

Section: Discussionmentioning

confidence: 99%

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Mycosis fungoides with spongiosis: A potential diagnostic pitfall

et al. 2019

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Background Mycosis fungoides (MF) is characterized by epidermotropic atypical lymphocytes in the absence of spongiosis. However, we describe an unusual presentation of MF with spongiosis, mimicking benign inflammatory dermatoses and highlight the importance of pathologic interpretation for diagnostic confirmation. Methods A cross‐sectional study of consecutive patients diagnosed with MF with spongiosis was conducted. The clinical, histopathologic, immunophenotypic, and molecular genetic features of cases were reviewed. Results We identified nine cases of MF (age range 34‐82 years; mean 75 years), with an initial diagnosis of dermatitis (6/9), psoriasis (4/9), or other inflammatory dermatoses (2/9). Pruritus, pain, and blisters were common clinical manifestations. The most common areas of involvement were the extremities (8/9). Epidermotropism with spongiosis was a central histopathological feature in all cases. Conclusion These cases highlight prominent spongiosis in MF and overlap with common benign inflammatory dermatoses. We present these cases to show the diagnostic pitfalls associated with spongiotic presentations of MF. Dermatitis, psoriasis, and other inflammatory skin conditions not responsive to standard therapy warrant further work‐up including biopsy to rule out MF. Multiple skin biopsies and review by a dermatopathologist with expertise in the diagnosis of cutaneous lymphoma is highly recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mycosis fungoides with spongiosis: A potential diagnostic pitfall

et al. 2019

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“…Acknowledging the possible coexistence and/or progression of both diseases, several authors recommend performing a skin biopsy for patients with presumed psoriasis before introducing systemic therapy, especially when presenting with poorly defined lesions or atypical presentations . None of our cases had histological confirmation of psoriasis before starting etanercept treatment.…”

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confidence: 81%

“…The link between psoriasis, MF, and anti‐TNF‐α agents remains elusive . The pathogenesis of both psoriasis and MF is strictly related to the abnormal function of skin‐homing T‐cells, specifically Th1 and Th17 populations; and several studies have identified an increased relative risk for lymphomas, including CTCLs, in psoriatic patients .…”

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confidence: 99%