Hypopigmented mycosis fungoides is a rare variant of mycosis fungoides (MF) that usually has a predilection for young individuals with dark complexion.
Objective:
The aim is to describe new cases of hypopigmented MF with confirmed T-cell receptor gene rearrangement analysis.
Methods:
This article includes case reports and a literature review.
Results:
Three out of four hypopigmented MF patients had a positive TCR gene rearrangement. A fifth patient is reported who had hypopigmented mycosis fungoides and classical Pautrier microabscesses, for whom no TCR gene rearrangement analysis was performed.
Conclusion:
Although hypopigmented MF has a predilection for dark-complexioned populations, it can also affect Caucasian patients. In challenging cases, polymerase chain reaction can be a useful method for detecting early cases of hypopigmented MF.
Get full access to this article
View all access options for this article.
References
1.
SmithNPSammanPD. Mycosis fungoides presenting with areas of cutaneous hypopigmentation. Clin Exp Dermatol1978; 3:213–216.
2.
BreathnachSMMcKeePHSmithNP. Hypopigmented mycosis fungoides: Report of five cases with ultrastructural observations. Br J Dermatol1982; 106:643–649.
3.
ZackheimHCEpsteinEHJrGrekinDA. Mycosis fungoides presenting as areas of hypopigmentation: Report of three cases. J Am Acad Dermatol1982; 6:340–345.
4.
DabskiKStollHLJrMilgromH. Unusual clinical presentation of epidermotropic cutaneous lymphoma. Small hypopigmented macules. Int J Dermatol1985; 24:108–115.
5.
GoldbergDJSchinellaRSKechijianP. Hypopigmented mycosis fungoides. Speculation about the mechanism of hypopigmentation. Am J Dermatopathol1986; 8:326–330.
6.
RustinMHAGriffithsMRidleyCM. The immunopathology of hypopigmented mycosis fungoides. Clin Exp Dermatol1986; 11:332–339.
LambrozaECohenSRPhelpsR. Hypopigmented variant of mycosis fungoides: Demography, histopathology, and treatment of seven cases. J Am Acad Dermatol1995; 32:987–993.
13.
RobertCBahlouliZChemalyP. Mycosis fungoides hypopigmenté. Ann Dermatol Venereol1995; 122:704–706.
14.
AmichaiBGrunwaldMHAvinoachI. Hypopigmented mycosis fungoides in a white female. J Dermatol1996; 23:425–426.
15.
Di LandroAMarchesiLNaldiL. A case of hypopigmented mycosis fungoides in a young Caucasian boy. Pediatr Dermatol1997; 14:449–452.
16.
RobertCMoulonguetIBaudotN. Hypopigmented mycosis fungoides in a light-skinned woman. Br J Dermatol1998; 139:341–343.
17.
GrunwaldMHAmichaiB. Localized hypopigmented mycosis fungoides in a 12-year-old Caucasian boy. J Dermatol1999; 26:70–71.
18.
El-HoshyKHashimotoK. Adolescence mycosis fungoides: An unusual presentation with hypopigmentation. J Dermatol1995; 22:424–427.
19.
Zucker-FranklinDKosannKlein BMPancakeB. Hypopigmented mycosis fungoides associated with human T cell lymphotropic virus type I tax in a pediatric patient. Pediatrics1999; 103:1039–1045.
20.
AndersonWKLiNBhawanJ. Polymerase chain reactiondenaturing gradient gel electrophoresis (PCR/DGGE)-based detection of clonal T-cell receptor γ gene rearrangements in paraffin-embedded cutaneous biopsies in cutaneous T-cell lymphoproliferative diseases. J Cutan Pathol1999; 26:176–182.
21.
WoodGSTungRMHaeffnerAC. Detection of clonal T-cell receptor gamma gene rearrangements in early mycosis fungoides/Sézary syndrome by polymerase chain reaction and denaturing gradient gel electrophoresis (PCR/DGGE). J Invest Dermatol1994; 103:34–41.
22.
RalfkiaerE. Immunohistochemical markers for the diagnosis of cutaneous lymphomas. Semin Diagn Pathol1991; 8:62–72.
23.
FivensonDPNickoloffBJ. Immunodiagnosis in cutaneous T-cell lymphoma: How does gene expression of the variable region of the T-cell receptor fit into the diagnostic and pathophysiologic picture of T-cell neoplasia. J Cutan Pathol1992; 19:1–5.
24.
AbelEALindaeMLHoppeRT. Benign and malignant forms of erythroderma: Cutaneous immunophenotypic characteristics. J Am Acad Dermatol1988; 19:1089–1095.
25.
KnovvlesDM. Immunophenotypic and antigen receptor gene rearrangement analysis in T-cell neoplasia. Am J Pathol1989; 134:761–785.
26.
TerhuneMHCooperKD. Gene rearrangements and T-cell lymphomas. Arch Dermatol1993; 129:1484–1490.
McCarthyKPSloaneJPKabarowskiJHS. The rapid detection of clonal T-cell proliferations in patients with lymphoid disorders. Am J Pathol1991; 138:821–828.
29.
BahlerDWBerryGOksenberryJ. Diversity of T-cell antigen receptor of variable genes used by mycosis fungoides cells. Am J Pathol1992; 140:1–8.
30.
BachelezH. The clinical use of molecular analysis of clonality in cutaneous lymphocytic infiltrates. Arch Dermatol1999; 135:200–202.
31.
Cur'oNServitjeOLuciaM. Genotypic analysis of cutaneous T-cell lymphoma. A comparative study of Southern blot analysis with polymerase chain reaction amplification of T-cell receptor-gamma gene. Br J Dermatol1997; 137:673–679.
32.
LiebmannRDAndersonBMcCarthyKP. The polymerase chain reaction in the diagnosis of early mycosis fungoides. J Pathol1997; 182:282–287.
33.
GuitardJKaulK. A new polymerase chain reaction-based method for the detection of T-cell clonality in patients with possible cutaneous T-cell lymphoma. Arch Dermatol1999; 135:158–162.
34.
SignorettiSMurphyMCangiGiuila M. Detection of clonal T-cell receptor and γ gene rearrangement in paraffin-embedded tissue by polymerase chain reaction and nonradioactive single-strand confirmational polymorphism analysis. Am J Pathol1999; 154:67–75.
