The evaluation of variants, subtypes and atypical forms of mycosis fungoides in a tertiary hospital

Background and Design: Clinical variants, subtypes, and early mycosis fungoides (MF) lesions may mimic other dermatoses. MF is the most common type of cutaneous T-cell lymphomas. In our study, we aimed to evaluate the clinical and histopathological features of patients with classical and variants, subtypes, or atypical forms of MF in our dermatology department. Materials and Methods: We retrospectively evaluated MF patients who were followed up in our dermatology department between 2008 and 2018. Demographic features (age and gender), duration of disease, clinical findings, stages, and treatments of patients with classical and atypical variants of MF were evaluated. Results: A total of 117 patients diagnosed clinically and histopathologically with MF were included in the study. Sixty-four of the patients were female (54%), and 53 were male (46%). The mean age at diagnosis was 55.6±16.03 years. The mean disease duration was 5.6 years. Sixtyone patients (52.1%) had stage IA, 20 patients (17%) had stage IB, 31 patients (26.4%) had stage IIA, three patients (2.5%) had IIB stage, one patient (0.85%) had IIIB stage and one patient (0.85%) had stage IVA disease. Atypical forms of the disease were detected in six patients (5.1%). Three (2.5%) of these cases were follicular MF, and one patient for each type of hypopigmented, ichthyosiform, and granulomatous MF. In addition to topical steroids, 99 patients (84.6%) received phototherapy, 20 patients (17%) had acitretin, six patients (5.1%) had topical bexarotene, four patients (3.4%) had methotrexate and one patient (0.85%) had systemic interferon treatment. Conclusion: MF variants, subtypes, atypical forms, and early lesions of MF may cause a delay in the diagnosis and treatment by mimicking other dermatoses. Suspicion of MF is warranted for early diagnosis and treatment of MF variants, subtypes, atypical forms of MF.

Üçüncü basamak bir hastanedeki mikozis fungoides, mikozis fungoides varyantlarý, alt tipleri ve atipik formlarýnýn klinikopatolojik deðerlendirilmesi

Amaç: Mikozis fungoides (MF) en sýk görülen kutanöz T hücreli lenfoma tipidir. MF’nin erken lezyonlarý, alt tipleri ve klinik varyantlarý, diðer dermatozlarý taklit edebilir. Çalýþmamýzda, hastanemiz dermatoloji kliniðinde takipli MF hastalarýnda klasik veya atipik seyir gösteren varyantlarýn klinik ve histopatolojik özelliklerini ortaya koymayý amaçladýk. Gereç ve Yöntem: Hastanemiz dermatoloji kliniðinde 2008-2018 yýllarý arasýnda takip edilen MF hastalarý retrospektif olarak incelendi. Hastalarýn sosyodemografik özellikleri, hastalýk süresi, klinik bulgularý, evreleri, verilen tedaviler ve atipik varyantlarý kaydedildi. Bulgular: Klinik ve histopatolojik olarak MF tanýlý 117 hasta çalýþmaya dahil edildi. Hastalarýn 64’ü kadýn (%54), 53’ü erkek (%46) idi. Olgularýn yaþ ortalamasý 55,6 idi. Hastalýðýn baþlangýcýndan tanýya kadar geçen süre ortalama 5, 6 yýldý. Altmýþ bir hasta (%52,1) evre IA, 20 hasta (%17) evre IB, 31 hasta (26,4) evre IIA, 3 hasta (%2,5) evre IIB, 1 hasta (%0,85) evre IIIB ve 1 hasta (%0,85) evre IVA idi. Altý olguda (%5,1) hastalýðýn atipik formlarý saptandý. Üç hasta (%2,5) foliküler MF, birer hasta ise hipopigmente, iktiyoziform ve granülomatöz MF idi. Tedavide topikal steroidlerin yanýnda 99 hastaya (%84,6) fototerapi, 20’sine (%17) asitretin, 4’üne (%3,4) metotreksat ve 1 hastaya (%0,85) sistemik interferon baþlandý. Sonuç: MF varyantlarý, subtipleri, atipik formlarý ve MF’nin erken lezyonlarý, diðer dermatozlarý taklit ederek taný ve tedavide gecikmeye neden olabilir. MF varyantlarýnýn, alt tiplerinin ve atipik formlarýnýn erken teþhisi ve tedavisi için MF’den þüphelenilmesi gereklidir.