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< Current issue
Dermatopathology: Practical & Conceptual October - December 2003
>
New Heights: “Hypopigmented mycosis fungoides” is not always mycosis fungoides!
Betina Werner, M.D.
Sonya Brown, M.D.
A. Bernard Ackerman, M.D.
Introduction
Patient one
Patient 2
The issue of hypopigmentation in mycosis fungoides
Our method for attempting to assess authenticity of a hypopigmented expression of mycosis fungoides
Definition of mycosis fungoides and criteria morphologically (clinical and histopathologic) for diagnosis of it
“Hypopigmented mycosis fungoides” in historical perspective
Our conclusions about “hypopigmented mycosis fungoides”
Summary of attributes of the patients who surely had “hypopigmented mycosis fungoides”
Photographs of clinical lesions and photomicrographs of the 19 patients with unquestionable hypopigmented mycosis fungoides
Summary of attributes of the patients who did not have “hypopigmented mycosis fungoides”
Photographs of clinical lesions and photomicrographs of the four patients who did not have hypopigmented mycosis fungoides:
Reasons we were unable to make a specific diagnosis of mycosis fungoides in some patients reputed to have it
Conclusions in the form of five questions and our own answers to them
How to differentiate, clinically and histopathologically, pityriasis alba and vitiligo from hypopigmented mycosis fungoides
A patient with stereotypical mycosis fungoides associated with hypopigmentation
A patient with stereotypical mycosis fungoides associated with both hypo- and hyperpigmentation
Closing Comment
Acknowledgements
References
SEE ALSO
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mycosis fungoides
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pityriasis alba
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vitiligo
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Conclusions in the form of five questions and our own answers to them
Is "hypopigmented mycosis fungoides" an authentic manifestation of mycosis fungoides? Yes.
Can mycosis fungoides present itself solely as hypopigmented macules and patches? Yes.
Are there pitfalls, clinically and histopathologically, in diagnosis of mycosis fungoides with hypopigmentation? Yes. Misinterpreting pityriasis alba and vitiligo as mycosis fungoides.
Do pigmentary changes in mycosis fungoides have implications for prognosis? No.
What is the explanation for hypopigmentation in mycosis fungoides? Not yet known.
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