Relationship Between Pityriasis Lichenoides and Mycosis Fungoides: A Clinicopathological, Immunohistochemical, and Molecular Study

Zaaroura, Hiba; Sahar, Dvora; Bick, Tova; Bergman, Reuven

doi:10.1097/dad.0000000000001057

Cited by 21 publications

(10 citation statements)

References 24 publications

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“…4,5) Recent evidence suggested a relationship between PL and MF, categorized into three groups: PL with T- cell infiltration, PL evolving to MF, and PL-like MF. [7][8][9][10] PL-like MF is a rare subtype of MF, described as causing similar benign skin lesions as those of PL but having histopathological findings as those of malignant MF, as illustrated in our case.…”

Section: Discussionmentioning

confidence: 87%

“…Pityriasis lichenniodes (PL) and MF are traditionally regarded as two different entities, representing the most common benign and malignant lymphoproliferative disorders in children, respectively. 9,10) PL is characterized by reactive cutaneous eruptions of erythematous scaly papules, while MF has a wide range of clinical presentations depending on its variants. Histopathologic findings of PL include necrotic keratinocytes, spongiosis, erythrocyte extravasation, and perivascular cell infiltration.…”

Section: Discussionmentioning

confidence: 99%

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A Case Report of Pityriasis Lichenoides-Like Mycosis Fungoides in Children: A Challenging Diagnosis

et al. 2021

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Primary cutaneous lymphomas are rare diseases among the general population, and even rarer in children. Mycosis fungoides (MF) is the most commonly diagnosed form in childhood. Several atypical clinical variants of MF have been reported, and pityriasis lichenoides-like MF (PL-like MF) is a recently described subtype. We report about a rare case of PL-like MF in an 11-year-old Malay boy with a 2-year history of multiple scaly erythematous papules associated with progressive and generalized hypopigmentation. This case report illustrates the significant dilemma in the diagnosis of the disease, particularly in the early stages, because its symptoms can mimic those of many common childhood inflammatory skin disorders. Later, the widespread hypopigmentation obscured the characteristic lesions, leading to misdiagnosis. Moreover, due to unfamiliarity of the disease, the diagnosis of PL-like MF was missed and delayed until only 2 years after the onset of the dermatosis. Therefore, primary care practitioners must have a high index of suspicion for this cutaneous neoplasm in children with persistent or worsening skin lesions, not responding to standard therapy, to ensure timely referral, diagnosis, and treatment.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

A Case Report of Pityriasis Lichenoides-Like Mycosis Fungoides in Children: A Challenging Diagnosis

et al. 2021

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“…Due to various common clinical, morphological, and molecular events, negative TCR cases require close attention and a mandatory follow-up, given that 20% of LPP will transform into CTCL [ 39 ]. According to Zaaroura et al, clonal T-cell receptor gene rearrangements may serve as clues of parapsoriasis evolving to MF [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

From Benign Inflammatory Dermatosis to Cutaneous Lymphoma. DNA Copy Number Imbalances in Mycosis Fungoides versus Large Plaque Parapsoriasis

Gug

Solovan

2021

Medicina

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Background and Objectives: Mycosis fungoides (MF) and large plaque parapsoriasis (LPP) evolution provide intriguing data and are the cause of numerous debates. The diagnosis of MF and LPP is associated with confusion and imprecise definition. Copy number alterations (CNAs) may play an essential role in the genesis of cancer out of genes expression dysregulation. Objectives: Due to the heterogeneity of MF and LPP and the scarcity of the cases, there are an exceedingly small number of studies that have identified molecular changes in these pathologies. We aim to identify and compare DNA copy number alterations and gene expression changes between MF and LPP to highlight the similarities and the differences between these pathologies. Materials and Methods: The patients were prospectively selected from University Clinic of Dermatology and Venereology Timișoara, Romania. From fresh frozen skin biopsies, we extracted DNA using single nucleotide polymorphism (SNP) data. The use of SNP array for copy number profiling is a promising approach for genome-wide analysis. Results: After reviewing each group, we observed that the histograms generated for chromosome 1–22 were remarkably similar and had a lot of CNAs in common, but also significant differences were seen. Conclusions: This study took a step forward in finding out the differences and similarities between MF and LPP, for a more specific and implicitly correct approach of the case. The similarity between these two pathologies in terms of CNAs is striking, emphasizing once again the difficulty of approaching and differentiating them.

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“…4 Prolonged clinical course (average 11 years) and marked diminution of apoptotic keratinocytes and CD7+ and CD8+ lymphocytes are associated with more risk of progression to MF. 19 The mechanism of development of hypopigmented lesions in PLC is mostly similar to what happens in hypopigmented interface T-cell dyscrasia, HMF and vitiligo and is attributed mainly to the cytotoxic effect of CD8+ T cells on the melanocytes, [20][21][22] and the resultant dysfunction in CD117/ MITF, that is essential for melanocyte survival and melanin production. 23 Moreover, the excess production of TNF-a by the cytotoxic CD8+ T cells in these three conditions leads to inhibition of basic fibroblast growth factor, a melanocyte stimulatory cytokine by keratinocytes with subsequent loss of pigmentation.…”

Section: Discussionmentioning

confidence: 99%

Hypopigmented lesions in pityriasis lichenoides chronica patients: Are they only post‐inflammatory hypopigmentation?

et al. 2021

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Background/Objectives: Pityriasis lichenoides chronica (PLC) lesions are reported to subside with post-inflammatory hypopigmentation (PIH); hence, the most widely perceived nature of hypopigmented macules in PLC is PIH. However, to the best of our knowledge, no studies describing histopathological findings in these lesions are reported in literature. The aim of this study is to evaluate the hypopigmented lesions encountered in PLC patients and to shed light on their histopathological features. Methods:A cross-sectional observational study included twenty-one patients with PLC recruited in a period of twelve months. Clinical characteristics of each patient were collected. A skin biopsy from hypopigmented lesions whenever present was taken and assessed with routine haematoxylin and eosin stain.Results: Seventeen patients (81%) were less than 13 years old. Most patients (85.7%) demonstrated diffuse distribution of lesions. Hypopigmented lesions were present on the face in 12 (57.14%) patients. Histopathologically, hypopigmented lesions showed features of post-inflammatory hypopigmentation in 19% of patients, residual PLC in 52.4% and active PLC 28.6% of patients. Conclusion:Hypopigmented lesions in PLC were noted mainly in younger ages, histopathologically they may show features of active or residual disease, beyond post-inflammatory hypopigmentation. Consequently active treatment for patients presenting predominantly with hypopigmented lesions could be required to control the disease.

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Relationship Between Pityriasis Lichenoides and Mycosis Fungoides: A Clinicopathological, Immunohistochemical, and Molecular Study

Abstract: A few PLs may evolve into MF. Prolonged clinical course, appearance of patches and larger plaques, markedly increased lymphocytic nuclear atypia, marked diminution of apoptotic keratinocytes and CD7 and CD8 lymphocytes, and clonal T-cell receptor gene rearrangement may serve as clues.

Cited by 21 publications

References 24 publications

A Case Report of Pityriasis Lichenoides-Like Mycosis Fungoides in Children: A Challenging Diagnosis

A Case Report of Pityriasis Lichenoides-Like Mycosis Fungoides in Children: A Challenging Diagnosis

From Benign Inflammatory Dermatosis to Cutaneous Lymphoma. DNA Copy Number Imbalances in Mycosis Fungoides versus Large Plaque Parapsoriasis

Hypopigmented lesions in pityriasis lichenoides chronica patients: Are they only post‐inflammatory hypopigmentation?

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