Journal of Skin Care and Cosmetic Surgery

“Unmasking the Beast”: A Retrospective Analysis of Clinical and Histopathological Features of Hypopigmented Mycosis Fungoides

Author(s): KN Lakmali Pathiraja*

Abstract
Background: Mycosis fungoides (MF) is the commonest type of cutaneous T-cell lymphoma. It typically has a chronic progressive course. In classic MF, there is infiltration of the skin with T lymphocytes, clinically manifest as erythematous or pigmented skin patches, mainly over covered body sites, which then progress in to infiltrative plaques and finally to tumors. Hypopigmented mycosis fungoides is observed in patients with pigmented skin, and it is categorized under patch stage of MF. However, compared to classic MF, expert observation has not reveled any progression beyond patch stage, any internal organ involvement or abnormal investigations results, compared to classic MF, even among those presenting with several years of hypopigmented mycosis fungoides. Research on hypopigmented Mycosis fungoides is lacking except for few case reports and few case series.
Methods: This is a descriptive study, which was conducted on patients who were diagnosed with hypopigmented mycosis fungoides.
Results: 90% of the patients were females and the mean age of the patients was 29.9 years. The patients had long duration of skin lesions and most of the time the correct diagnosis was missed. However, none of the patients had any internal organ involvement or abnormal investigation results, even among those presenting with several years of the disease. Zero deaths were observed during the studied period. On the other hand, revealing the diagnosis has made the patients anxious and, has significantly affected their quality of life. Most of the patients (90%) were treated with PUVA, with variable response.
Conclusion: Hypopigmented mycosis fungoides is categorized under cutaneous T cell lymphoma. However, as the disease shows very benign, nature, is it justified to classify and manage hypopigmented mycosis fungoides as same as classic MF? Further discussions needed regarding classification of hypopigmented mycosis fungoides. Similarly, more clinical research should be conducted in a view of identifying an effective treatment for hypopigmented mycosis fungoides.