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2021, Number 3

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Rev Cent Dermatol Pascua 2021; 30 (3)

Hyperpigmented mycosis fungoides of the face and folds in adults: a prospective study of a new clinical variety

Domínguez-Gómez MA, Estrada-Ramírez KP, Morales-Sánchez MA, Jurado-Santa CF, Navarrete-Franco G, Ramos-Garibay JA, González-González M, Peralta-Pedrero ML

Language: Spanish
References: 24
Page: 131-138
PDF size: 372.57 Kb.


ABSTRACT

Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma (CTCL) worldwide, which has numerous variants, both from a clinical and histopathological point of view. The presentation in the form of hyperpigmented spots is a rare variety. At the "Dr. Ladislao de la Pascua" Dermatological Center a special manifestation of it has been detected, with affectation of the face and folds, which has not been previously described. Objective: Communicate the clinical and histopathological characteristics of these cases, as well as their treatment. Material and methods: A prospective cohort study of patients with a clinical and histopathological diagnosis of hyperpigmented mycosis fungoides of the face and folds was carried out. Results: Of 290 patients with a diagnosis of MF studied in this Dermatological Center over a period of 12 years, 27 patients (9.3%) presented hyperpigmented lesions on the face and folds, 23 of them (85%) belonged to the female sex, the oldest age group. Affected was between 46 and 56.3 years old, with an evolution time of 12 months ± 91.88 (minimum of 1 month and maximum of 384 months). The median time to diagnosis was 157 days (15-2,155). 74% (20) had head disease, 88% (24) neck, 70% (19) trunk, 55% (15) upper extremities and 11% (3) lower. Histopathological results were reported as definitive MF in 52% (14) of the cases, compatible in 30% (8) and in 5 of the cases the diagnosis was made by clinical-histopathological correlation. Treatment with a topical calcineurin inhibitor was indicated in 22 patients (81%) with remission and gradual depigmentation. Different medications were used in the others. The limitation of this study was that, as it is a new clinical variety, it is necessary to carry out immunophenotype and genetic studies. Conclusion: We consider that hyperpigmented mycosis fungoides of the face and folds is a clinical variant not previously described, so we propose that it be included within the clinic-pathological varieties of cutaneous T-cell lymphoma.


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