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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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Introduction
Two patients seen in consultation were the impetus to this undertaking. Each was said to have hypopigmented mycosis fungoides on the basis of features clinically and of findings histopathologically; in actuality, both had pityriasis alba. The experience with those patients motivated us to review, comprehensively and critically, the subject of "hypopigmented mycosis fungoides" as it has been written about during the past 30 years.
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