Institutional members access full text with Ovid®

Share this article on:

Histopathological Changes Seen in Mycosis Fungoides Patients After Phototherapy

Dusmez Apa, Duygu MD; Serinsoz Pfeiffer, Ebru MD, PhD; Baz, Kiymet MD; Arzu Kanik, Emine PhD; İnandioğlu, Pinar MD

American Journal of Dermatopathology: May 2010 - Volume 32 - Issue 3 - pp 276-280
doi: 10.1097/DAD.0b013e3181c89e8c
Clinicopathologic Correlation

Early stage (IA, IB, IIA) mycosis fungoides (MF) has long been treated with various agents including oral psoralen plus UVA (PUVA), broadband and narrowband. The histopathological changes seen after phototherapy have not been clearly described. Twenty-three skin biopsy specimens of MF patients treated with phototherapy both UVA and UVB were evaluated before and 3 months after phototherapy. The clinical and histomorphological response were evaluated. Various types of epidermotropism: such as single cells, haloed cells, linearly arranged single cells, pagetoid spread, and Pautrier microabscesses were noted. Stratum corneum was classified as normal, hyperkeratotic, and parakeratotic. The epidermal thickness was noted as normal, atrophic, and hypertrophic. Spongiotic microvesiculation, presence of dilated dermal vessels, was investigated. Papillary dermis fibrosis, the presence of plasma cells, eosinophils, and extravasated erythrocytes were also examined. Epidermal hyperplasia, dermal fibrosis, loss of parakeratotic pattern, and inflammatory infiltrate were frequently observed after therapy. After phototherapy, the atypical cells rarely formed “Pautrier microabscess” or made a “linear pattern” at the base of epidermis. The cells other than lymphocytes (plasma cells, eosinophils, and erythrocytes) should also be considered regarding the phototherapy effect. A pathology report of a MF patient who has undergone successful phototherapy would describe changes resulting from phototherapy-such as fibrosis or “lack of dermal inflammation” and the absence of active epidermal cellular changes such as “Pautrier microabscess” or “linearly arranged cells.”

From the University of Mersin, School of Medicine, Mersin, Turkey.

Reprints: Duygu Dusmez Apa, MD, Associate Professor of Pathology, Department of Pathology, Mersin University, School of Medicine, Mersin 33079, Turkey (e-mail: dusmezduygu@hotmail.com).

© 2010 Lippincott Williams & Wilkins, Inc.