Study of the prevalence of Hypopigmented Mycosis Fungoides among Patients Presenting Hypopigmented Lesions

Main Article Content

Chutika Srisuttiyakorn, M.D. Patcharasiri Bocam, M.D.

Abstract

Background: Hypopigmented mycosis fungoides (MF) is a variant of primary cutaneous T-cell lymphoma. Although the prognosis of hypopigmented mycosis fungoides is excellent, the diagnosis is usually missed.


Objective: The study aimed to identified the prevalence of patients with hypopigmented mycosis fungoides presenting hypopigmentation in Phramongkutklao Hospital, Bangkok, Thailand. We also reported the characteristic of hypopigmented mycosis fungoides among patients presenting hypopigmentation and compared clinical presentations between patients with a diagnosis of hypopigmented mycosis fungoides and patients with other diagnoses


Materials and Methods: We conducted a retrospective among 56 patients presenting hypopigmentation and receiving skin biopsies at Division of Dermatology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand between January 2016 to December 2021. The data parameters including demographic data, clinical manifestations (symptoms, size and morphology of the lesions, e.g., scale, margin, erythema, atrophy, mottled hypopigmentation, involved body surface area and distribution, histopathologic reports, special stains, final diagnosis, further investigations, treatments, follow-up duration and result of the treatments were recorded.


Results: The prevalence of hypopigmented mycosis fungoides among patient presenting with hypopigmentation was 16.1%. Compared with patients with other diagnoses, patients with hypopigmented mycosis fungoides usually had lesions with ill-defined margins (P-value=0.045) and presence of atrophy lesion (P-value=0.023).


Conclusion: The prevalence of hypopigmented mycosis fungoides involved 16.1% of patients presenting hypopigmentation. The presence of ill-defined margins and atrophic lesions led to suspected hypopigmented MF in our study. This data could be useful in epidemiologic information and might be adapted when choosing lesions for biopsy to diagnose MF.

Keywords: Hypopigmented mycosis fungoides, hypopigmentation, prevalence

Article Details

How to Cite
SRISUTTIYAKORN, Chutika; BOCAM, Patcharasiri. Study of the prevalence of Hypopigmented Mycosis Fungoides among Patients Presenting Hypopigmented Lesions. Medical Research Archives, [S.l.], v. 12, n. 6, june 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5428>. Date accessed: 02 july 2024. doi: https://doi.org/10.18103/mra.v12i6.5428.
Section
Research Articles

References

1. Willemze R. Cutaneous T-cell Lymphoma. In: Bolognia JL, Jorizzo JL, Cerroni L, eds. Dermatology.4thed. New York, NY: Elsevier; 2018: 2131-2147.
2. Willemze R, Cerroni L, Kempf W, et al. The 2018 update of the WHO-EORTC classification for primary cutaneous lymphomas [published correction appears in Blood. 2019 Sep 26;134(13):1112].Blood. 2019;133(16):1703-1714. doi:10.1182/blood-2018-11-881268
3. Yamashita T, Abbade LP, Marques ME, Marques SA. Mycosis fungoides and Sézary syndrome: clinical, histopathological and immunohistochemical review and update.An Bras Dermatol. 2012;87(6):817-830. doi:10.1590/s0365-05962012000600001
4. Furlan FC, Sanches JA. Hypopigmented mycosis fungoides: a review of its clinical features and pathophysiology.An Bras Dermatol. 2013;88(6):954-960. doi:10.1590/abd1806-4841.20132336
5. Ardigó M, Borroni G, Muscardin L, Kerl H, Cerroni L. Hypopigmented mycosis fungoides in Caucasian patients: a clinicopathologic study of 7 cases.J Am Acad Dermatol. 2003;49(2):264-270. doi:10.1067/s0190-9622(03)00907-1
6. Lambroza E, Cohen SR, Phelps R, Lebwohl M, Braverman IM, DiCostanzo D. Hypopigmented variant of mycosis fungoides: demography, histopathology, and treatment of seven cases.J Am Acad Dermatol. 1995;32(6):987-993. doi:10.1016/0190-9622(95)91337-8
7. Pope E, Weitzman S, Ngan B, et al. Mycosis fungoides in the pediatric population: report from an international Childhood Registry of Cutaneous Lymphoma.J Cutan Med Surg. 2010;14(1):1-6. doi:10.2310/7750.2009.08091
8. Hassab-El-Naby HM, El-Khalawany MA. Hypopigmented mycosis fungoides in Egyptian patients.J Cutan Pathol. 2013;40(4):397-404. doi:10.1111/cup.12093
9. Alsaleh QA, Nanda A, Al-Ajmi H, et al. Clinicoepidemiological features of mycosis fungoides in Kuwait, 1991-2006.Int J Dermatol. 2010;49(12):1393-1398. doi:10.1111/j.1365-4632.2010.04567.x
10. Das JK, Gangopadhyay AK. Mycosis fungoides with unusual vitiligo-like presentation.Indian J Dermatol Venereol Leprol. 2004;70(5):304-306.
11. Inchara YK, Rajalakshmi T. Early mycosis fungoides vs. inflammatory mimics: how reliable is histology?.Indian J Dermatol Venereol Leprol. 2008;74(5):462-466. doi:10.4103/0378-6323.42644
12. Koorse S, Tirumalae R, Yeliur IK, Jayaseelan E. Clinicopathologic profile of hypopigmented mycosis fungoides in India.Am J Dermatopathol. 2012;34(2):161-164. doi:10.1097/DAD.0b013e31822e6877
13. Saleem MD, Oussedik E, Picardo M, Schoch JJ. Acquired disorders with hypopigmentation: A clinical approach to diagnosis and treatment.J Am Acad Dermatol. 2019;80(5):1233-1250.e10. doi:10.1016/j.jaad.2018.07.070
14. Cerroni L, Sander CA, Smoller BR, Willemze R, Siebert R. Mycosis fungoides. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. editors. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th ed. Lyon: IRPC; 2017. p 385-389.
15. Rodney IJ, Kindred C, Angra K, Qutub ON, Villanueva AR, Halder RM. Hypopigmented mycosis fungoides: a retrospective clinicohistopathologic study.J Eur Acad Dermatol Venereol. 2017;31(5):808-814. doi:10.1111/jdv.13843
16. Khopkar U, Doshi BR, Dongre AM, Gujral S. A study of clinicopathologic profile of 15 cases of hypopigmented mycosis fungoides.Indian J Dermatol Venereol Leprol. 2011;77(2):167-173. doi:10.4103/0378-6323.77456
17. Luo Y, Liu Z, Liu J, Liu Y, Zhang W, Zhang Y. Mycosis Fungoides and Variants of Mycosis Fungoides: A Retrospective Study of 93 Patients in a Chinese Population at a Single Center.Ann Dermatol. 2020;32(1):14-20. doi:10.5021/ad.2020.32.1.14
18. Abdel-Halim M, El-Nabarawy E, El Nemr R, Hassan AM. Frequency of hypopigmented mycosis fungoides in Egyptian patients presenting with hypopigmented lesions of the trunk.Am J Dermatopathol. 2015;37(11):834-840. doi:10.1097/DAD.0000000000000379
19. Pruksaeakanan C, Teyateeti P, Patthamalai P, Thumrongtharadol J, Chairatchaneeboon M. Primary Cutaneous Lymphomas in Thailand: A 10-Year Retrospective Study.Biomed Res Int. 2021;2021:4057661. Published 2021 Jun 11. doi:10.1155/2021/4057661
20. Wongpraparut C, Setabutra P. Phototherapy for hypopigmented mycosis fungoides in Asians.Photodermatol Photoimmunol Photomed. 2012;28(4):181-186. doi:10.1111/j.1600-0781.2012.00662.x
21. Amorim GM, Niemeyer-Corbellini JP, Quintella DC, Cuzzi T, Ramos-E-Silva M. Hypopigmented mycosis fungoides: a 20-case retrospective series.Int J Dermatol. 2018;57(3):306-312. doi:10.1111/ijd.13855
22. Castano E, Glick S, Wolgast L, et al. Hypopigmented mycosis fungoides in childhood and adolescence: a long-term retrospective study.J Cutan Pathol. 2013;40(11):924-934. doi:10.1111/cup.12217
23. El-Shabrawi-Caelen L, Cerroni L, Medeiros LJ, McCalmont TH. Hypopigmented mycosis fungoides: frequent expression of a CD8+ T-cell phenotype.Am J Surg Pathol. 2002;26(4):450-457. doi:10.1097/00000478-200204000-00006
24. Torres-Victoria TR, Domínguez-Gómez MA, Jurado-Santa Cruz F, Morales-Sánchez MA. Prognostic factors for disease remission in early-stage mycosis fungoides: A retrospective cohort study in a Mexican population.JAAD Int. 2022;8:157-159. Published 2022 Jun 17. doi:10.1016/j.jdin.2022.06.005
25. Rattanakaemakorn P, Ploydaeng M, Udompanich S, Thadanipon K, Rutnin S, Rajatanavin N. Phototherapy as a treatment of early-stage mycosis fungoides and predictive factors for disease recurrence: A 17-year retrospective study.Indian J Dermatol Venereol Leprol. 2021;87(5):645-650. doi:10.25259/IJDVL_555_19
26. Akaraphanth R, Douglass MC, Lim HW. Hypopigmented mycosis fungoides: treatment and a 6(1/2)-year follow-up of 9 patients.J Am Acad Dermatol. 2000;42(1 Pt 1):33-39. doi:10.1016/s0190-9622(00)90006-9