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2.
An. bras. dermatol ; 96(4): 458-471, July-Aug. 2021. tab
Artigo em Inglês | LILACS | ID: biblio-1285098

RESUMO

Abstract Cutaneous T-cell lymphomas are a heterogeneous group of lymphoproliferative disorders, characterized by infiltration of the skin by mature malignant T cells. Mycosis fungoides is the most common form of cutaneous T-cell lymphoma, accounting for more than 60% of cases. Mycosis fungoides in the early-stage is generally an indolent disease, progressing slowly from some patches or plaques to more widespread skin involvement. However, 20% to 25% of patients progress to advanced stages, with the development of skin tumors, extracutaneous spread and poor prognosis. Treatment modalities can be divided into two groups: skin-directed therapies and systemic therapies. Therapies targeting the skin include topical agents, phototherapy and radiotherapy. Systemic therapies include biological response modifiers, immunotherapies and chemotherapeutic agents. For early-stage mycosis fungoides, skin-directed therapies are preferred, to control the disease, improve symptoms and quality of life. When refractory or in advanced-stage disease, systemic treatment is necessary. In this article, the authors present a compilation of current treatment options for mycosis fungoides and Sézary syndrome.


Assuntos
Humanos , Neoplasias Cutâneas/terapia , Linfoma Cutâneo de Células T , Micose Fungoide/terapia , Síndrome de Sézary/terapia , Qualidade de Vida
3.
An. bras. dermatol ; 96(1): 27-33, Jan.-Feb. 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1152805

RESUMO

Abstract Background: Mycosis fungoides is the most common type of cutaneous T-cell lymphoma. Most early-stage mycosis fungoides cases follow an indolent course, hence considered by doctors a relatively easy condition. However, since mycosis fungoides bears the title of cancer, patients might perceive it differently. Objective: To investigate patients' illness perception, and its relationships to quality of life, depression, anxiety, and coping among early-stage mycosis fungoides patients. Methods: A cross-sectional questionnaire-based study was conducted. Patients from a single tertiary medical center completed the Revised Illness Perception Questionnaire, the MF/SS-CTCL Quality of Life scale, the Hospital Anxiety and Depression Scale, and The Mental Adjustment to Cancer Scale. Results: Thirty patients (25 males, five females, mean age 51.60) with stage I mycosis fungoides were enrolled. Mycosis fungoides had a little impact on patients' daily life, quality of life, and levels of depression and anxiety, and they generally coped well. Disease understanding was low and was negatively correlated with impairment to quality of life and depression. Patients felt that stress and worry were features of the disease's etiology. Study limitations: A small sample of patients was included. Conclusion: Patients with early-stage mycosis fungoides adapt well to their disease. Psychological interventions should be aimed at improving patients coping style and enhancing illness understanding, in order to maintain high quality of life.


Assuntos
Humanos , Masculino , Feminino , Neoplasias Cutâneas , Micose Fungoide , Percepção , Qualidade de Vida , Adaptação Psicológica , Estudos Transversais , Pessoa de Meia-Idade
4.
Gac. méd. Méx ; 157(1): 43-49, ene.-feb. 2021. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1279072

RESUMO

Resumen Introducción: La micosis fungoide es el linfoma primario de células T en piel más frecuente, con expresividad clínica heterogénea. Objetivo: Reportar las variedades clínicas y las características sociodemográficas de pacientes con micosis fungoide tratados en un hospital dermatológico. Métodos: Se incluyeron 290 pacientes con diagnóstico clínico e histopatológico de micosis fungoide atendidos en el transcurso de 11 años. Se realizó descripción sociodemográfica de los pacientes, quienes se clasificaron conforme las variantes clínicas e histopatológicas. Resultados: 58 % de los casos de micosis fungoide se presentó en mujeres y 42 % en hombres. La variedad clínica más común fue la clásica en 46.2 %; la discrómica representó 35.2 %, del cual la hipopigmentada fue la más representativa (7.6 %); la poiquilodérmica constituyó 4.1 % y la foliculotrópica, 3.1 %. La variedad papular se presentó en seis pacientes (2.1 %), la de placa única en tres (1 %) y la ictiosiforme, siringotrópica y la piel laxa granulomatosa, en un paciente cada una. La variedad granulomatosa se encontró en 0.7 % y 1.4 % presentó eritrodermia. Conclusiones: La variedad clínica más frecuente de micosis fungoide fue la clásica en fase de placa, seguida de las variedades discrómicas. Otras variedades clínicas representaron 18.6 %.


Abstract Introduction: Mycosis fungoides (MF) is the most common primary skin T-cell lymphoma, which is characterized for a heterogeneous clinical expressivity. Objective: To report clinical variants and sociodemographic characteristics in patients with MF under the care of a dermatological hospital. Methods: 290 patients with MF clinical and histopathological diagnosis attended to over the course of 11 years were included. Sociodemographic description of patients was made, who were classified according to clinical and histopathological variants. Results: MF was recorded in 57.9 % of women and 42 % of men. The most common clinical variant was the classic type in 46.2 %; dyschromic variants accounted for 35.2 %, out of which hypopigmented MF was the most representative (17.6 %); poikilodermatous MF accounted for 4.1 %, and folliculotropic, for 3.1%. The papular variant occurred in six patients (2.1 %), the single-plaque variety in three (1%), and the ichthyosiform, syringotropic and granulomatous slack skin varieties occurred in one patient each. The granulomatous variant was found in 0.7 %, and 1.4 % had erythroderma. Conclusions: The most common MF clinical variant was classic plaque stage, followed by dyschromic variants. Other clinical variants accounted for 18.6 %.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Neoplasias Cutâneas/patologia , Micose Fungoide/patologia , Neoplasias Cutâneas/classificação , Neoplasias Cutâneas/terapia , Estudos Retrospectivos , Estudos de Coortes , Micose Fungoide/classificação , Micose Fungoide/terapia , Resultado do Tratamento
5.
An. bras. dermatol ; 95(3): 326-331, May-June 2020. tab, graf
Artigo em Inglês | LILACS, Coleciona SUS | ID: biblio-1130881

RESUMO

Abstract Background: Diagnosis of mycosis fungoides is challenging due to the non-specificity of clinical and histopathological findings. The literature indicates an average delay of 4-6 years for a conclusive diagnosis. Refinement of the histopathological criteria for the diagnosis of patients in early stages of the disease is considered of interest. Objectives: To study the histopathological aspects of early-stage mycosis fungoides and the applicability, in a retrospective form, of the diagnostic algorithm proposed by Pimpinelli et al. Methods: Observational, retrospective, transversal study based on revision of histopathological exams of patients with suspected mycosis fungoides. Medical records were reviewed, and complementary immunohistochemistry performed. Results: Sixty-seven patients were included. The most frequent histopathological features were superficial perivascular lymphoid infiltrate (71.6%), epidermotropism (68.7%), lymphocytic atypia (63.8%), hyperkeratosis (62.7%) and acanthosis (62.7%). Forty-three patients scored 4 points at the algorithm, by clinical and histological evaluation. Immunohistochemistry was performed on 23 of the 24 patients with less than 4 points. Of those 23, 22 scored 1 point, allowing a total of 61 patients (91%) with the diagnosis of early-stage mycosis fungoides. Study limitations: Its retrospective character, reduced sample size and incomplete application of the algorithm. Conclusions: Application of the Pimpinelli et al. algorithm, even in an incomplete form, increased the percentage of cases diagnosed as mycosis fungoides. Routine application of the algorithm may contribute to earlier and specific management and improvement of the patients' outcome.


Assuntos
Humanos , Masculino , Feminino , Algoritmos , Micose Fungoide/diagnóstico , Micose Fungoide/patologia , Valores de Referência , Biópsia , Imuno-Histoquímica , Linfócitos/patologia , Estudos Transversais , Reprodutibilidade dos Testes , Estudos Retrospectivos , Progressão da Doença , Pessoa de Meia-Idade
7.
Dermatol. argent ; 26(1): 2-10, 2020. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1146328

RESUMO

El síndrome de Sézary (SS) es una rara y agresiva variante leucémica del linfoma cutáneo de células T, de pronóstico ominoso. Se caracteriza por presentar la tríada eritrodermia, linfadenopatías y linfocitos T neoplásicos circulantes. El diagnóstico está dado por la clínica, el estudio histopatológico, la citometría de flujo y el reordenamiento genético del receptor del linfocito T. En esta revisión se analizan la presentación clínica, la histopatología, el diagnóstico y el pronóstico de este síndrome. (AU)


Sézary syndrome (SS) is a rare and aggressive leukemic cutaneous T-cell lymphoma with poor prognosis. Is characterized by a triad of erythroderma, lymphadenopathy and circulating neoplastic T cells. Diagnosis is made by clinical features, histopathology, flow cytometry and T-cell receptor gene rearrangements. In this review we will analyze clinical presentation, histopathology, diagnosis and prognosis of SS. (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias Cutâneas/diagnóstico , Síndrome de Sézary/diagnóstico , Prognóstico , Micose Fungoide/diagnóstico , Dermatite/diagnóstico , Diagnóstico Diferencial
8.
Int. j. odontostomatol. (Print) ; 13(4): 446-451, dic. 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1056483

RESUMO

RESUMEN: Las papilas fungiformes pigmentadas de la lengua, cuyas siglas son PFPT, del inglés Pigmented fungiform papillae of the tongue, es una condición asintomática, no progresiva que se presenta en personas de piel oscura, en las cuales las papilas fungiformes cambian de su color rosado natural, a una gama de café a negro. El objetivo de nuestro estudio es reportar y describir las caractetísticas clínicas, dermatoscópicas e histológicas de la PFPT por primera vez en una serie de pacientes ecuatorianos. Estudio prospectivo simple en el Centro de Especialidades Dermatológicas Garzón, período de dos años. El criterio de inclusión fue cambio de coloración a nivel lingual, se recolectaron datos demográficos, clínicos; fotografías, dermatoscopía, y biopsia, para tinción con hematoxilina-eosina y Fontana-Mason. Examinamos 8.640 pacientres, 15 (12 mujeres, 3 varones) fueron diagnosticados de PFPT. La edad promedio fue 31 años, todos fueron mestizos, con fototipo de piel predominante III y IV. El tiempo de evolución promedio en años fue 5,8. Ninguno tuvo antescedentes familiares o personales relacionados a la patología. La evaluación clínica demostró que el patrón de distribución de acuerdo a la clasificación de Holzwanger en la gran mayoría fue tipo II (13/15). En todos los casos la dermatoscopía y la histología fueron específicas demostrando hallazgos típicos y comprobatorios de PFPT.


ABSTRACT: The pigmented fungiform papillae of the tongue, whose acronyms are PFPT, of the English Pigmented fungiform papillae of the tongue, is an asymptomatic, nonprogressive condition that occurs in dark-skinned people, in which the fungiform papillae change their color natural pink, to a range of brown to black. The aim of our study is to report and describe the clinical, dermatoscopic and histological characteristics of the PFPT for the first time in a series of Ecuadorian patients. A simple prospective study at the Garzón Dermatological Specialty Center, a two-year period. The inclusion criteria was lingual change of color, demographic, clinical data were collected; photographs, dermatoscopy, and biopsy, for staining with hematoxylin-eosin and FontanaMason. We examined 8,640 patients, 15 (12 women, 3 men) were diagnosed with PFTP. The range of age was 31 years, all were mestizos, with skin phototype predominant III and IV. The range of evolution time in years was 5.8. None had family or personal precedents related to the pathology. The clinical evaluation showed that the pattern of distribution according to the Holzwanger classification in the great majority was type II (13/15). In all cases, the dermatoscopy and histology were specific, demonstrating typical and evidential findings of PFPT.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Neoplasias Cutâneas , Papilas Gustativas/patologia , Doenças da Língua/patologia , Hiperpigmentação/patologia , Melaninas/análise , Doenças da Língua/etiologia , Biópsia , Estudos Prospectivos , Micose Fungoide/complicações , Hiperpigmentação/etiologia , Dermoscopia/métodos , Corantes , Equador
9.
An. bras. dermatol ; 93(6): 913-915, Nov.-Dec. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1038285

RESUMO

Abstract: The growth factor receptor c-kit (CD117) is expressed in immature T-cells and in some advanced forms of mycosis fungoides. c-kit gene mutation results in unrestricted neoplastic proliferation. We aimed to detect by PCR the most frequent exon mutations in seventeen plaque-stage MF patients, in their perilesional skin and in healthy skin donors. We secondarily evaluated CD117 expression by immunohistochemistry in plaque-stage and tumor-stage MF. We detected no mutation in c-kit gene and low CD117 expression was confirmed on atypical cells in one patient. Complete c-kit exon and intron sequences should be assessed and more sensitive sequencing method could be also applied.


Assuntos
Humanos , Masculino , Feminino , Idoso , Éxons/genética , Micose Fungoide/genética , Proteínas Proto-Oncogênicas c-kit/genética , Mutação/genética , Imuno-Histoquímica , Estudos de Casos e Controles , Expressão Gênica , Reação em Cadeia da Polimerase , Estudos Prospectivos
10.
An. bras. dermatol ; 93(5): 680-685, Sept.-Oct. 2018. tab
Artigo em Inglês | LILACS | ID: biblio-949949

RESUMO

Abstract: Background: Mycosis fungoides (MF) is the most common subtype of cutaneous T-cell lymphoma. TNMB system is the staging method used in MF, and it not only guides therapeutic management, but represents the main prognostic factor. In order to improve the prognostic evaluation, the Cutaneous Lymphoma International Prognostic Index (CLIPi) was proposed. Objective: To evaluate the performance of CLIPi score for prognostic analysis in patients with early stage MF. Methods: This is a retrospective cross-sectional observational study, with exploratory analysis. The outcome variables were disease progression and related death. Results: One hundred and two patients were stratified according to CLIPi score, being the majority classified as low risk. Patients with intermediate or high risk presented disease progression more frequently than those with low risk (PR: 1.2 / p = 0.004 / 95%CI: 1.0 - 1.6). The same did not occur with the variable related death. In addition, survival rates were not consistent with risk stratification. Study Limitations: Small sample and its retrospective analysis. Conclusions: Since CLIPi score was proposed, four other studies that we could consult showed conflicting results, similar to the present study. Further studies are necessary for a recommendation of its use.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Micose Fungoide/patologia , Prognóstico , Neoplasias Cutâneas/mortalidade , Brasil/epidemiologia , Estudos Transversais , Taxa de Sobrevida , Estudos Retrospectivos , Seguimentos , Linfoma Cutâneo de Células T/mortalidade , Linfoma Cutâneo de Células T/patologia , Micose Fungoide/mortalidade , Síndrome de Sézary/patologia , Progressão da Doença , Estadiamento de Neoplasias
11.
An. bras. dermatol ; 93(4): 546-552, July-Aug. 2018. tab
Artigo em Inglês | LILACS | ID: biblio-949907

RESUMO

Abstract: Background: Mycosis fungoides is the most common form of primary cutaneous lymphoma, with an indolent, slowly progressive course and 88% five-year survival rate. The diagnosis is challenging, especially in the early stages, and usually relies on a good clinical-histopathological correlation. Objective: The aim was to establish the clinical and epidemiological profile of patients with early-stage mycosis fungoides. Methods: This was a retrospective cross-sectional observational study with an exploratory analysis. Outcome variables were disease progression and mycosis fungoides-related death. Results: One hundred and two patients were included. The majority were white males, with a mean age of 55.6 years. Mean time from onset of lesions to diagnosis was 51.08 months. The majority of patients were classified as IB stage according to TNMB. Mean follow-up time was 7.85 years. Disease progression was seen in 29.4% of the patients. Death related to the disease occurred in 7.9% of patients. Plaque lesions, involvement of more than 10% of the body surface, altered lactate dehydrogenase and beta-2-microglobulin, and stage IB were significantly associated with disease progression, and altered lactate dehydrogenase and beta-2-microglobulin also correlated with higher frequency of deaths. Study limitations: Small sample and retrospective design. Conclusions: The clinical and epidemiological profile of patients with early-stage mycosis fungoides in our sample corroborates reports in the literature. Diagnostic delay in our series is also consistent with previous findings, but the rate of disease progression, despite treatment, was higher than reported in the literature.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Neoplasias Cutâneas/patologia , Micose Fungoide/patologia , Neoplasias Cutâneas/epidemiologia , Brasil/epidemiologia , Criança , Prevalência , Estudos Transversais , Estudos Retrospectivos , Micose Fungoide/epidemiologia , Progressão da Doença , Estadiamento de Neoplasias
13.
Rev. medica electron ; 40(2): 471-479, mar.-abr. 2018. ilus
Artigo em Espanhol | LILACS, CUMED | ID: biblio-902300

RESUMO

RESUMEN El síndrome de Sézary constituye la fase leucémica de la micosis fungoide caracterizado por eritrodermia, adenopatías superficiales y células atípicas en sangre. Predomina en los hombres con una proporción 2/1 respecto a las mujeres, y en las edades entre los 60 y 70 años de edad. La enfermedad es de difícil tratamiento, con un pronóstico reservado por su baja supervivencia. Por ser infrecuente y su posible similitud con otras dermatosis, se presenta un caso con antecedentes de psoriasis vulgar con 5 años de evolución, que hacía aproximadamente 6 meses, se encontraba sin mejoría en brote de agudización a pesar de los tratamientos indicados (AU).


ABSTRACT Sezary syndrome is the leukemic part of the fungoid mycosis, characterized by erythroderma, surface adenopathies and atypical cells in blood. It predominates in men with a 2/1 proportion in respect to women, and in ages ranging from 60 to 70 years. It is a difficult treated disease, with a reserved prognosis because of the low survival. Due to its infrequency and possible similarity to other dermatosis, it is presented a case with antecedents of vulgar psoriasis of 5 years evolution, without improvement for around 6 months, in acute outbreak in spite of the indicated treatments (AU).


Assuntos
Humanos , Masculino , Idoso , Psoríase/complicações , Psoríase/tratamento farmacológico , Neoplasias Cutâneas , Síndrome de Sézary/complicações , Síndrome de Sézary/diagnóstico , Síndrome de Sézary/etiologia , Síndrome de Sézary/mortalidade , Síndrome de Sézary/patologia , Síndrome de Sézary/epidemiologia , Exame Físico , Dermatopatias , Terapêutica , Atenção Secundária à Saúde , Biópsia/métodos , Micose Fungoide/complicações , Micose Fungoide/epidemiologia , Serviço Hospitalar de Oncologia , Testes Diagnósticos de Rotina
14.
An. bras. dermatol ; 93(1): 33-38, Jan.-Feb. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-887147

RESUMO

Abstract: Background: While phototherapy is a well-established treatment for many dermatoses, data from the literature regarding its use in elderly patients are quite limited. Objective: In this study, we aimed to determine the phototherapy indications in geriatric patients and to evaluate the effectiveness and reliability of phototherapy in this group. Methods: This study included 95 patients of 65 years of age and older who were treated in our phototherapy unit between 2006 and 2015. The data for this study were collected retrospectively from patient follow-up forms in the phototherapy unit. Results: Phototherapy was administered to 28 (29.5%) patients for mycosis fungoides, 25 (26.3%) patients foplaque type psoriasis, 12 (12.6%) patients for palmoplantar psoriasis, 12 (12.6%) patients for generalized pruritus, and 18 (19%) for other dermatoses. Of the patients, 64.2% had received a narrowband UVB (NB-UVB), 21.1% oral psoralen UVA (PUVA), and 14.7% local PUVA treatment. A complete response was achieved in 76.9-85.7% of the mycosis fungoides and in 73.71-100% of the psoriasis vulgaris patients treated with NB-UVB and PUVA, respectively. All the patients with generalized pruritus were treated with NB-UVB, and 80% of these patients achieved significant improvement. The erythema rate was found to be 0.43% per session for NB-UVB treatment and 0.46% per session for PUVA treatment as a side effect. Study limitations: The limitations of our study are that it was retrospective and the remission durations of the patients are not known. Conclusion: This study showed that phototherapy is effective and reliable in the elderly population with proper dose increases and close follow-up.


Assuntos
Humanos , Masculino , Feminino , Idoso , Fototerapia/métodos , Prurido/terapia , Psoríase/terapia , Neoplasias Cutâneas/terapia , Micose Fungoide/terapia , Terapia PUVA/métodos , Segurança , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento
15.
Rev. méd. Minas Gerais ; 28: [1-5], jan.-dez. 2018.
Artigo em Português | LILACS | ID: biblio-970385

RESUMO

Micose fungoide é uma neoplasia dos linfócitos T helper que afeta a pele e geralmente não apresenta manifestações extracutâneas por muitos anos. Já a micose fungoide hipocromiante (MFH) corresponde a um subtipo daquela com melhor prognóstico e que se apresenta com lesões hipocrômicas a acrômicas, com distribuição mais comum em tronco, regiões proximais de extremidades e cintura pélvica. O diagnóstico é firmado pela apresentação clínica aliada à histopatologia, que evidencia epidermotropismo com linfócitos atípicos. A doença geralmente apresenta boa resposta ao tratamento, o qual pode ser realizado com fototerapia com raios ultravioleta A (UVA), ultravioleta B (UVB), mostarda nitrogenada tópica, carmustina tópica e irradiação cutânea com elétrons. Descreve-se o caso de uma criança com máculas hipocrômicas que surgiram inicialmente no abdome, posteriormente se estendendo para raiz de coxas e região inguinal. As lesões apresentavam descamação fina, porém sem eritema ou prurido e ausência de linfonodomegalia palpável. A princípio o caso foi conduzido como eczemátide hipocromiante, mas o paciente apresentou agravamento importante das lesões em poucos meses apesar do tratamento, sendo assim, aventada a hipótese diagnóstica de MFH. Duas biópsias de pele foram realizadas, e os exames anatomopatológico e imunohistoquímica evidenciaram certo epidermotropismo, mas sem atipia de linfócitos. Foi orientado helioterapia domiciliar, com exposição corporal de 10 minutos no período da manhã, além do uso de emolientes e cuidados gerais com a pele, com relativa boa resposta. O acompanhamento é semestral e caso haja modificação do quadro, a biópsia com estudo histopatológico e a imunohistoquímica serão realizados novamente. (AU)


Mycosis fungoides is a type of cancer of the T helper lymphocytes that affects the skin and generally has no extracutaneous manifestations for many years. Otherwise, hypopigmented mycosis fungoides corresponds to a subtype with better prognosis and presents as hypopigmented or achromatic lesions, with more widespread distribution in the trunk, proximal parts of extremities and pelvic girdle. The diagnosis is confirmed by clinical presentation and histopathology, which shows epidermotropism and atypical lymphocytes. The disease usually show good response to treatment, which is performed with phototherapy with ultraviolet A (UVA), ultraviolet B (UVB), topical nitrogen mustard, topical carmustine and cutaneous irradiation with electrons. We describe the case of a child with hypochromic taint that initially appeared in the abdomen, later extending to root thighs and groin. The lesions had fine scaling, absence of erythema or itching, without the presence of palpable lymph node enlargement. At first the case was conducted as pytiriasis alba, but the patient had significant aggravation of injuries in a few months in spite of the treatment, thus mooted diagnosis of hypopigmented mycosis fungoides. Two skin biopsies were performed, and the histological and immunohistochemical tests showed epidermotropism but no atypia of lymphocytes. It was guided home heliotherapy, with body exposure of 10 minutes in the morning, besides the use of emollients and general skin care, with a relatively good response. The follow-up is bi-annually and if there is a modification in the condition, the biopsy with histopathological study and immunohistochemistry will be performed again. (AU)


Assuntos
Humanos , Terapia Ultravioleta/estatística & dados numéricos , Micose Fungoide/radioterapia , Linfoma , Anormalidades da Pele/terapia , Micose Fungoide/tratamento farmacológico , Terapêutica/métodos , Criança
16.
Appl. cancer res ; 38: 1-4, jan. 30, 2018. ilus
Artigo em Inglês | LILACS, Inca | ID: biblio-910535

RESUMO

Background: Mycosis fungoides (MF), a T-cell lymphoma, is the most common variant of primary cutaneous lymphomas. The discrete clinical aspect of the early patch-stage and an overlapping clinical presentation with other erythematosquamous skin diseases make the diagnosis of MF challenging. Histopathology is the gold standard for the diagnosis of MF. However, in early stages, MF can simulate inflammatory diseases, presenting reactive lymphocytes and absence of lymphocytic cytologic atypia. Consecutive biopsies are often necessary from several clinically suspect sites. Previous studies evaluated Reflectance Confocal Microscopy (RCM) as a promising tool for MF diagnosis because it offers the opportunity to analyze skin structures non-invasively at a 'quasi-histopathologic' resolution and to guide the most representative site for biopsy. Case presentation: We present a 76 years-old woman with a 5-year history of erythematous plaques and patches. She had had 5 previous skin biopsies with a pattern suggestive of nummular eczema. The history and the clinical presentation led to the suspicion of MF. RCM examination was performed and two lesions were marked for biopsy. The histopathology exam confirmed the diagnosis of MF. The patient was submitted to topical treatment with total remission of the lesions. Conclusions: The mean time from onset of symptoms to diagnosis is 6 years and the delay in diagnosis results in delay for adequate therapy. Therefore, the selection of the biopsy site is crucial to avoid unrepresentative samples. Mancebo et al. recently published the largest cohort of cutaneous T.cell lymphoma examined with RCM. 83 lesions were evaluated, and the authors confirmed that this image technique was effective in to guide the most representative site for the biopsy. We believe that further and larger studies will clarify it and defining a diagnostic algorithm for the RCM diagnosis of MF.


Assuntos
Humanos , Feminino , Idoso , Linfoma de Células T , Micose Fungoide/patologia , Microscopia Confocal/instrumentação , Diagnóstico Precoce
17.
Arq. bras. med. vet. zootec. (Online) ; 69(6): 1461-1465, nov.-dez. 2017. ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-910033

RESUMO

A female adult dog, with a four-month history of pain and intense pruritus, which eventually resulted in sudden death, was referred for necropsy. Postmortem examination showed thoracic and abdominal serum-sanguineous exudates, multifocal infiltrative renal masses, and similar tumors in the heart. Histopathology revealed midsize infiltrative neoplastic proliferation composed of round cells, sparse cytoplasm, and large hyperchromatic nuclei. Immunohistochemistry revealed CD3+ and CD20-immunoexpression. Histopathological and immunohistochemical findings confirmed the diagnosis of epitheliotropic lymphoma with cardiac and renal metastasis.(AU)


Foi encaminhado para necropsia um cão adulto do sexo feminino, com histórico de dor e prurido intenso com evolução de quatro meses, que acabou resultando em morte súbita. O exame post mortem mostrou presença discreta de exsudato serossanguinolento em cavidades torácica e abdominal, massas renais infiltrativas multifocais e tumores semelhantes no coração. O exame histopatológico revelou proliferação neoplásica infiltrativa composta de células redondas, com citoplasma escasso, e grandes núcleos hipercromáticos. A análise imuno-histoquímica mostrou imunoexpressão CD3+e CD20. Os achados histopatológicos e imuno-histoquímico confirmaram o diagnóstico de linfoma epiteliotrópico com metástase cardíaca e renal.(AU)


Assuntos
Animais , Feminino , Cães , Neoplasias Cardíacas/veterinária , Neoplasias Renais/veterinária , Micose Fungoide/veterinária , Metástase Neoplásica/diagnóstico , Síndrome de Sézary/veterinária , Autopsia/veterinária , Imuno-Histoquímica/veterinária , Linfoma Cutâneo de Células T/veterinária
18.
Medicina (Ribeiräo Preto) ; 50(4): 261-264, jul.-ago 2017.
Artigo em Inglês | LILACS | ID: biblio-877424

RESUMO

Lymphomatoid papulosis (LyP) is defined as a chronic, recurrent, self-healing papulonecrotic or papulonodular skin disease with histologic features suggestive of a (CD30-positive) malignant lymphoma. In up to 20% of patients, LyP are preceded by, associated with, or followed by another type of cutaneous or systemic lymphoma, generally mycosis fungoides (MF), primary cutaneous anaplastic large cell lymphoma (C-ALCL). In this case, we describe a case of MF that preceded and continued to coexist with LyP type C.(AU)


A papulose linfomatóide (LyP) é definida como uma doença cutânea papulonecrótica ou papulonodular crônica, recorrente, com características histológicas sugestivas de linfoma maligno (CD30-positivo). Em até 20% dos pacientes, o LyP é precedido por, associado ou seguido por outro tipo de linfoma cutâneo ou sistêmico, geralmente micose fungóide (MF), linfoma cutâneo primário de células grandes anaplásicas (C-ALCL). Neste caso, descrevemos um caso de MF que precedeu e continuou a coexistir com LyP tipo C. (AU)


Assuntos
Humanos , Feminino , Adulto , Linfoma , Linfoma Anaplásico Cutâneo Primário de Células Grandes , Papulose Linfomatoide , Micose Fungoide , Linfócitos T
19.
An. bras. dermatol ; 92(5,supl.1): 73-75, 2017. graf
Artigo em Inglês | LILACS | ID: biblio-887068

RESUMO

Abstract Mycosis fungoides is a cutaneous T-cell lymphoma with various clinical and pathological presentations. Early lesions are nonspecific, which hinders early diagnosis. The folliculotropic subtype is manifested as acneiform lesions, follicular papules or erythematous plaques mainly on the face, neck and upper trunk. Histopathology shows dense lymphocytic infiltrate surrounding and infiltrating the hair follicles. A case of difficult histopathological diagnosis with florid and unusual skin lesions mainly on the face is reported.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Pele/patologia , Micose Fungoide/patologia , Neoplasias Cutâneas/patologia , Biópsia , Imuno-Histoquímica
20.
An. bras. dermatol ; 92(5,supl.1): 92-94, 2017. graf
Artigo em Inglês | LILACS | ID: biblio-887103

RESUMO

Abstract Hyperpigmented mycosis fungoides is an extremely rare subtype of mycosis fungoides. It presents as multiple pigmented macules and patches without poikilodermatous changes and characterized by a CD8+ phenotype on immunohistochemistry. This report describes a typical case of hyperpigmented mycosis fungoides in a 62-year-old woman, who presented with a 7-year history of multiple hyperpigmented macules and patches on the trunk and right leg with progression over this half a year. Histology and immunohistochemical staining of skin samples confirmed the diagnosis of mycosis fungoides. She received psoralen plus ultraviolet A (PUVA) therapy. After an 8-week treatment, the erythematous changes cleared without recurrence during a 6-month follow-up period. An intractable hyperpigmented patch should raise the clinical suspicion of mycosis fungoides with sequential skin biopsy.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Micose Fungoide/patologia , Hiperpigmentação/patologia , Terapia PUVA/métodos , Neoplasias Cutâneas/tratamento farmacológico , Biópsia , Imuno-Histoquímica , Micose Fungoide/tratamento farmacológico , Resultado do Tratamento , Hiperpigmentação/tratamento farmacológico , Linfócitos T CD8-Positivos/patologia
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