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  In this article
    Abstract
    Introduction
    Case Report
    Discussion
    References

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CASE REPORT
Year : 2001  |  Volume : 67  |  Issue : 2  |  Page : 98-99

Patch stage of mycosis fungoides


Department of Dermatology and Venereology, MMHRC, Madurai, India

Correspondence Address:
MMHRC, Lake Area, Melur Road, Madurai-625107, India

   Abstract 

Parapsoriasis is aeon troversial topic. There are many studies regarding the relationship of parapsoriasis to lymphoma\ but no correlation between histology and clinical appearance. Parapsoriasis satisfies histologic criteria for mycosis fungoides and therefore it should be considered as patch stage of mycosis fungoides. A 30-year-old man presented with scaly skin lesions over the trunk since 4 years. Routine blood and urine investigations were normal. Skin biopsy from the lesion revealed atypical lymphocytes within the epidermis without spongiosis.

How to cite this article:
Mavarkar L. Patch stage of mycosis fungoides. Indian J Dermatol Venereol Leprol 2001;67:98-9


How to cite this URL:
Mavarkar L. Patch stage of mycosis fungoides. Indian J Dermatol Venereol Leprol [serial online] 2001 [cited 2019 Jun 18];67:98-9. Available from: http://www.ijdvl.com/text.asp?2001/67/2/98/11119



   Introduction Top

Mycosis fungoides is a condition characterised by the infiltration of the skin with plaques and nodules composed of T-lymphocytes. Patch stage of mycosis fungoides was first described by Sanchez and Ackerman in 1979.[1] But this term is not well accepted by many dermatologists. Here is the report of such a case on a controversial topic.

   Case Report Top

A 30-year-old-man presented with scaly skin lesions over the trunk since 4 years. There was history of hyperpigmentation as well as atrophy of the skin at a few places. Cutaneous examination revealed multiple ill defined large scaly patches with hyperpigmentation and epidermal atrophy at a few places without telangiectasia. Other systems were normal. There was no significant lymphadenopathy. Routine blood and urine investigations were normal. Skin biopsy from the lesion revealed atypical lymphocytes within the epidermis without spongiosis.

   Discussion Top

Since the introduction of the term parapsoriasis by Brocq in 1902, many terminologies have been proposed, resulting in controversies and confusion.[2] It is recommended that the use of the term parapsoriasis be discontinued.[3] There are many studies regarding relationship of parapsoriasis to lymphoma, but no correlation between histology and clinical appearance.[4] Histology of early patch lesions of mycosis fungoides reveal an increased number of mononuclear cells distributed singly or in small collections within an epidermis devoid of spongiotic microvesiculation.[1] Other important features are lacunae surrounding intraepidermal mononuclear cells which gives them the appearance of "haloed cells". Atypical mononuclear cells are not necessary for the diagnosis of early patch lesions of mycosis fungoides.[1] Ackerman feels that parapsoriasis is the patch stage of mycosis fungoides.[5] The use of the term parapsoriasis should be discontinued and it should be considered as patch stage of mycosis fungoides. 

   References Top

1.Sanchez JL, Ackerman AB. The patch stage of mycosis fungoides. Criteria for histologic diagnosis. Am J Dermatopathol 1979 ; 1 : 5-26.  Back to cited text no. 1    
2.Brocq L. Les Parapsoriasis. Ann Dermatol Syphiligr 1902 ; 3: 433-468.  Back to cited text no. 2    
3.Mackie RM. Lymphomas and leukaemias. In ; Rook A, Wilkinson DS, Ebling FJG, eds. Textbook of Dermatology, 5th ed, Oxford, England: Blackwell Scientific Publications. 1992; 3: 2107- 2134.  Back to cited text no. 3    
4.Samman PD. The natural history of parapsoriasis en plaques and prereticulotic poikiloderma. Br J Dermatol 1972; 87: 405-411.  Back to cited text no. 4    
5.Ackerman AB. If small plaque parapsoriasis is a cutaneous T - cell lymphoma, even an "abortive" one, it must be mycosis fungoides. Arch Dermatol 1996; 132 : 562-566.  Back to cited text no. 5    

 

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Online since 15th March '04
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