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Hypopigmented mycosis fungoides

S E Whitmore1, E Simmons-O'Brien, F S Rotter

  • 1Department of Dermatology, Johns Hopkins Medical Institutions, Baltimore, Md.

Archives of Dermatology
|April 1, 1994
PubMed
Summary

Hypopigmented mycosis fungoides, a rare skin condition, is often misdiagnosed. This study highlights its occurrence in nonwhite individuals, often before age 20, suggesting it may be underreported.

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Area of Science:

  • Dermatology
  • Oncology

Background:

  • Macular hypopigmented mycosis fungoides (MF) is exceptionally rare, with only five cases previously reported.
  • Clinical presentation is often misdiagnosed, leading to delayed diagnosis.

Observation:

  • Three African-American males (ages 9, 15, 22) were diagnosed with MF after initial misdiagnosis of pityriasis alba.
  • Histopathology revealed typical MF changes and T-cell marker studies showed a loss of CD7 antigen.
  • One patient achieved complete remission with psoralen plus UV-A (PUVA) therapy.

Findings:

  • Hypopigmented MF can occur in nonwhite individuals.
  • Onset of hypopigmented MF is frequently before age 20.
  • The perceived rarity may be due to underreporting and misdiagnosis.

Implications:

  • Increased awareness of hypopigmented MF in nonwhite populations and younger individuals is crucial for timely diagnosis.
  • Further research is needed to understand the epidemiology and diagnostic challenges of this MF subtype.
  • Early diagnosis and appropriate treatment, such as PUVA therapy, can lead to favorable outcomes.

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