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Lichenoid changes in mycosis fungoides
J Guitart1, M Peduto, W A Caro
1Department of Dermatology, Northwestern University Medical Center, Chicago, IL 60611, USA.
Journal of the American Academy of Dermatology
|March 1, 1997
Summary
Mycosis fungoides (MF) can present with lichenoid tissue reactions (LTR), mimicking lichen planus. This presentation is often linked to severe itching and may indicate a worse prognosis for MF patients.
Area of Science:
- Dermatology
- Pathology
- Oncology
Background:
- The lichenoid tissue reaction (LTR) is a histological pattern observed in various skin conditions.
- Mycosis fungoides (MF) is a type of cutaneous T-cell lymphoma with diverse histological presentations.
Purpose of the Study:
- To investigate the clinical and pathological characteristics of mycosis fungoides (MF) presenting with a prominent lichenoid tissue reaction (LTR).
- To identify features that differentiate lichenoid MF from other dermatoses, particularly lichen planus.
Main Methods:
- Retrospective analysis of clinical and pathological data.
- Evaluation of 12 patients diagnosed with MF and LTR.
Main Results:
- Intense pruritus was the predominant symptom in most patients (10/12).
- Half of the patients experienced an aggressive disease course, with four progressing to Sézary syndrome.
- Four deaths occurred, two from Sézary syndrome and two from advanced patch/plaque MF.
- Histological findings such as lymphocyte atypia, basal cell epidermotropism, plasma cells, and eosinophils were noted.
Conclusions:
- A subset of mycosis fungoides patients exhibit lichenoid changes, which can resemble lichen planus.
- Lichenoid MF is associated with significant pruritus and may suggest a poorer prognosis.
- Specific pathological features can aid in distinguishing lichenoid MF from lichen planus.
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