RESUMO
Mycosis fungoides (MF) is a slowly progressive form of cutaneous T-cell lymphomas (CTCL). MF is classified into 4 subtypes including folliculotropic MF (FMF). Infiltration of both hair follicles and eccrine glands is included in the FMF classification and designated as syringotropic MF (STMF), an exceedingly rare form of CTCL. We report an additional case of STMF. The clinical course of syringotropic CTCL is more benign than FMF, suggesting that despite similar clinical presentations, they are molecularly distinct diseases. Clinical characteristics can help differentiate STMF from FMF. Skin-directed therapies are less effective in STMF than FMF. With distinct clinical characteristics, histopathologic findings, and disease course, syringotropic CTCL should be considered a subtype entity in the spectrum of adnexotropic MF. J Drugs Dermatol. 2022;21(12):1362-1364. doi:10.36849/JDD.6779.
Assuntos
Linfoma Cutâneo de Células T , Micose Fungoide , Neoplasias Cutâneas , Humanos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Micose Fungoide/diagnóstico , Folículo Piloso/patologiaRESUMO
Tumor necrosis factor (TNF) antagonists have revolutionized management for various autoimmune and inflammatory conditions, including rheumatoid arthritis (RA), inflammatory bowel disease, hidradenitis suppurativa, psoriatic arthritis, and plaque psoriasis. However, adverse effects may necessitate switching to another biologic with a different mechanism of action. Here we report TNF-α antagonist-induced lupus syndrome (TAILS) revealed by interstitial granulomatous dermatitis (IGD), in the atypical context of Crohn's disease (CD).
Assuntos
Doenças Autoimunes , Doença de Crohn , Dermatite , Lúpus Eritematoso Cutâneo , Humanos , Adalimumab/efeitos adversos , Doenças Autoimunes/induzido quimicamente , Doenças Autoimunes/complicações , Doença de Crohn/tratamento farmacológico , Dermatite/complicações , Inibidores do Fator de Necrose Tumoral/efeitos adversos , Lúpus Eritematoso Cutâneo/induzido quimicamente , Lúpus Eritematoso Cutâneo/complicaçõesAssuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Micose Fungoide/patologia , Neoplasias Cutâneas/patologia , Adulto , Feminino , Humanos , Micose Fungoide/tratamento farmacológico , Qualidade de Vida , Neoplasias Cutâneas/dietoterapia , Resultado do TratamentoRESUMO
Secondary syphilis has been known since the late 19th century as the great imitator; however, some experts now regard cutaneous lymphoma as the great imitator of skin disease. Either disease, at times an equally fastidious diagnosis, has reported to mimic each other even. It is thus vital to consider these possibilities when presented with a patient demonstrating peculiar skin lesions. No other manifestation of secondary syphilis may pose such quandary as a rare case of rupioid syphilis impersonating cutaneous lymphoma. We present such a case, of a 36-year-old HIV positive male, misdiagnosed with aggressive cutaneous lymphoma, actually exhibiting rupioid syphilis thought secondary to immune reconstitution inflammatory syndrome (IRIS).
RESUMO
BACKGROUND: Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma, which typically presents as a patch or plaque in early-stage disease. Phototherapy including psoralen plus ultraviolet A and ultraviolet B are well-established treatment modalities in management of early-stage MF. Only a limited number of reports have evaluated the efficacy of 308-nm excimer laser in therapy of cutaneous T-cell lymphoma. OBJECTIVE: We sought to evaluate the efficacy of 308-nm excimer laser (XTRAC, PhotoMedex, Montgomeryville, PA) in patients with stage IA to IIA MF. METHODS: We reviewed the clinical and laboratory characteristics of 6 consecutive patients given the diagnosis of refractory MF who underwent treatment with excimer laser. RESULTS: We found that the 308-nm excimer laser is a safe and well-tolerated alternative therapy for early-stage MF. In addition, we were able to delineate criteria to help predict treatment response. Our data showed that 4 (66%) patients achieved clinical improvement (3 complete responses, 1 partial response), 1 had stable disease, and 1 had progressive disease. LIMITATIONS: This was a retrospective study consisting of 6 patients. A prospective study with a larger sample size would be desirable for future studies. CONCLUSION: The use of 308-nm excimer laser in the treatment of stage IA to IIA MF showed clinical and pathological benefit for patients with isolated lesions or lesions in areas that may be difficult to treat because of anatomic location.
Assuntos
Lasers de Excimer , Terapia com Luz de Baixa Intensidade/métodos , Linfoma Cutâneo de Células T/cirurgia , Micose Fungoide/radioterapia , Neoplasias Cutâneas/radioterapia , Adulto , Idoso , Estudos de Coortes , Feminino , Seguimentos , Humanos , Linfoma Cutâneo de Células T/patologia , Masculino , Pessoa de Meia-Idade , Micose Fungoide/patologia , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias Cutâneas/patologia , Fatores de Tempo , Resultado do TratamentoRESUMO
We report a unique case of periocular nonnecrobiotic necrobiotic xanthogranuloma in a 52-year-old white woman with Sjögren syndrome who was subsequently found to have an immunoglobulin G paraproteinemia and coexisting small lymphocytic lymphoma. Therapy with fludarabine, cytoxan, and rituximab (FCR) resulted in a dramatic resolution of her sicca symptoms and periocular xanthogranulomas. This case further illustrates the association of hematolymphoid disorders with cutaneous xanthogranulomatous disease and the importance of additional appropriate laboratory and radiologic investigation for the accurate diagnosis of an underlying malignancy.
Assuntos
Leucemia Linfocítica Crônica de Células B/complicações , Xantogranuloma Necrobiótico/etiologia , Paraproteinemias/complicações , Síndrome de Sjogren/complicações , Anticorpos Monoclonais Murinos/uso terapêutico , Antineoplásicos/uso terapêutico , Biópsia , Ciclofosfamida/uso terapêutico , Quimioterapia Combinada , Pálpebras/patologia , Feminino , Humanos , Imunossupressores/uso terapêutico , Leucemia Linfocítica Crônica de Células B/imunologia , Leucemia Linfocítica Crônica de Células B/patologia , Pessoa de Meia-Idade , Xantogranuloma Necrobiótico/tratamento farmacológico , Xantogranuloma Necrobiótico/imunologia , Xantogranuloma Necrobiótico/patologia , Paraproteinemias/tratamento farmacológico , Paraproteinemias/imunologia , Paraproteinemias/patologia , Rituximab , Síndrome de Sjogren/tratamento farmacológico , Síndrome de Sjogren/imunologia , Síndrome de Sjogren/patologia , Resultado do Tratamento , Vidarabina/análogos & derivados , Vidarabina/uso terapêuticoAssuntos
Carcinoma Basocelular/terapia , Carcinoma de Células Escamosas/terapia , Neoplasias Cutâneas/terapia , Carcinoma Basocelular/etiologia , Carcinoma Basocelular/genética , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patologia , Curetagem , Dessecação , Progressão da Doença , Humanos , Terapia de Imunossupressão/efeitos adversos , Período Intraoperatório , Cirurgia de Mohs , Ácidos Polimetacrílicos/uso terapêutico , Radioterapia/efeitos adversos , Recidiva , Fatores de Risco , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Cistos de Tarlov/patologiaAssuntos
Carcinoma de Célula de Merkel/terapia , Neoplasias Cutâneas/terapia , Algoritmos , Carcinoma de Célula de Merkel/diagnóstico , Carcinoma de Célula de Merkel/tratamento farmacológico , Carcinoma de Célula de Merkel/radioterapia , Carcinoma de Célula de Merkel/cirurgia , Seguimentos , Humanos , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/radioterapia , Neoplasias Cutâneas/cirurgiaRESUMO
The proper method of biopsy and definitive surgical excision of cutaneous melanoma is vital for optimal patient outcome. Clearly, the present authors' understanding of the pathophysiology of cutaneous melanoma continues to change at a rapid pace. Indeed, as the present authors' research efforts begin to expose some of the mysteries of melanoma, so do they begin to better understand the intricacies of this dreaded cancer. This article will highlight methods of biopsy for melanoma and the management of the primary tumor. The present authors review current recommendations for excision margins for the primary tumor, usefulness of lymphoscintigraphy, timing of definitive surgical excision, and issues unique for head and neck melanoma.