Subject(s)
Antineoplastic Agents/therapeutic use , Benzenesulfonates/therapeutic use , Head and Neck Neoplasms/drug therapy , Hemangiosarcoma/drug therapy , Pyridines/therapeutic use , Skin Neoplasms/drug therapy , Aged , Antineoplastic Agents/administration & dosage , Benzenesulfonates/administration & dosage , Female , Head and Neck Neoplasms/pathology , Hemangiosarcoma/pathology , Humans , Middle Aged , Niacinamide/analogs & derivatives , Phenylurea Compounds , Pyridines/administration & dosage , Scalp , Skin Neoplasms/pathology , Sorafenib , Treatment OutcomeABSTRACT
A 57-year-old Japanese man with tumor-stage mycosis fungoides suddenly presented multiple small papules on the right chest. Histopathology of a biopsy specimen from the papules revealed medium-to-large pleomorphic lymphoid cells throughout the entire dermis but not in the epidermis, and the large cells expressed CD30 antigen. These newly-developed papules underwent spontaneous remission in the following 3 months. We reviewed the reported cases of mycosis fungoides, which showed CD30-positive large cell transformation and those of CD30-positive lymphoproliferative disorders associated with mycosis fungoides.
Subject(s)
Lymphomatoid Papulosis/pathology , Mycosis Fungoides/pathology , Skin Neoplasms/pathology , Biopsy , Cell Transformation, Neoplastic , Humans , Ki-1 Antigen/analysis , Lymphomatoid Papulosis/drug therapy , Male , Middle Aged , Mycosis Fungoides/drug therapy , PUVA Therapy , Skin Neoplasms/drug therapyABSTRACT
Psoralen plus UVA (PUVA) is used as a very effective treatment modality for various diseases, including psoriasis and cutaneous T-cell lymphoma. PUVA-induced immune suppression and/or apoptosis are thought to be responsible for the therapeutic action. However, the molecular mechanisms by which PUVA acts are not well understood. We have previously identified platelet-activating factor (PAF), a potent phospholipid mediator, as a crucial substance triggering ultraviolet B radiation-induced immune suppression. In this study, we used PAF receptor knockout mice, a selective PAF receptor antagonist, a COX-2 inhibitor (presumably blocking downstream effects of PAF), and PAF-like molecules to test the role of PAF receptor binding in PUVA treatment. We found that activation of the PAF pathway is crucial for PUVA-induced immune suppression (as measured by suppression of delayed type hypersensitivity to Candida albicans) and that it plays a role in skin inflammation and apoptosis. Downstream of PAF, interleukin-10 was involved in PUVA-induced immune suppression but not inflammation. Better understanding of PUVA's mechanisms may offer the opportunity to dissect the therapeutic from the detrimental (ie, carcinogenic) effects and/or to develop new drugs (eg, using the PAF pathway) that act like PUVA but have fewer side effects.