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Koebner Phenomenon and Mycosis Fungoides.

Lebas E, Libon F, Nikkels AF - Case Rep Dermatol (2015)

Bottom Line: Mycosis fungoides (MF) is the most frequent type of primary cutaneous T-cell/NK-cell lymphoma.The Koebner phenomenon is defined as the appearance of cutaneous lesions on previously noninvolved skin following trauma and is observed in a series of cutaneous diseases including psoriasis, lichen planus, viral warts, molluscum contagiosum, etc.This report suggests that some MF patients may experience Koebner phenomenon-induced MF lesions and that MF should be added to the long list of skin diseases potentially exhibiting the Koebner phenomenon.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, CHU Sart Tilman, University of Liège, Liège, Belgium.

ABSTRACT
Mycosis fungoides (MF) is the most frequent type of primary cutaneous T-cell/NK-cell lymphoma. The Koebner phenomenon is defined as the appearance of cutaneous lesions on previously noninvolved skin following trauma and is observed in a series of cutaneous diseases including psoriasis, lichen planus, viral warts, molluscum contagiosum, etc. In this case report, 3 patients with longstanding MF are presented, the 1st with the appearance of a circumscribed early-stage type MF lesion rapidly following a surgical excision of an infundibular cyst, the 2nd with the appearance of a unique unilateral palmar tumoral MF lesion at the pressure site of a crutch, and the 3rd presented localized MF early stage lesions at the friction site of a belt. This report suggests that some MF patients may experience Koebner phenomenon-induced MF lesions and that MF should be added to the long list of skin diseases potentially exhibiting the Koebner phenomenon.

No MeSH data available.


Related in: MedlinePlus

Palmar tumoral MF at the pressure site of a crutch.
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Figure 2: Palmar tumoral MF at the pressure site of a crutch.

Mentions: A 51-year-old woman presented with tumoral MF (T3N0M0B0). After 2 months of high-dose interferon (IntronA, 3 × 9.106 UI per week), the tumoral lesions slunk to slightly infiltrated plaques. Biological and clinical tolerance was unremarkable. The interferon dose was tapered over 4 weeks, and methotrexate maintenance therapy was initiated (10 mg per week). She remained stable for several months. After a fall, she used a crutch with her right arm due to low back pain. About 1 month after her fall, she presented a tumoral MF-like lesion of the palmar aspect of her right hand. The lesion developed precisely at the pressure site of her crutch (fig. 2). She had not experienced any other local traumatism. No other T3-type lesions occurred on other body sites. No new drugs were initiated. A 3-mm punch biopsy was performed, and histology confirmed tumoral MF. The patient refused to return to interferon therapy as the lesion was not bothering her. Topical potent steroids (clobetasol propionate 0.05 cream, 1×/day) and weekly intralesional infiltrations of corticosteroids (triamcinolone acetonide 10 mg/ml, Albicort®; Sanofi-Aventis) were administered with an acceptable clinical regression after 5 weeks. As her condition improved steadily, she refrained from using her crutch, and no recurrence was observed on her hand.


Koebner Phenomenon and Mycosis Fungoides.

Lebas E, Libon F, Nikkels AF - Case Rep Dermatol (2015)

Palmar tumoral MF at the pressure site of a crutch.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4637793&req=5

Figure 2: Palmar tumoral MF at the pressure site of a crutch.
Mentions: A 51-year-old woman presented with tumoral MF (T3N0M0B0). After 2 months of high-dose interferon (IntronA, 3 × 9.106 UI per week), the tumoral lesions slunk to slightly infiltrated plaques. Biological and clinical tolerance was unremarkable. The interferon dose was tapered over 4 weeks, and methotrexate maintenance therapy was initiated (10 mg per week). She remained stable for several months. After a fall, she used a crutch with her right arm due to low back pain. About 1 month after her fall, she presented a tumoral MF-like lesion of the palmar aspect of her right hand. The lesion developed precisely at the pressure site of her crutch (fig. 2). She had not experienced any other local traumatism. No other T3-type lesions occurred on other body sites. No new drugs were initiated. A 3-mm punch biopsy was performed, and histology confirmed tumoral MF. The patient refused to return to interferon therapy as the lesion was not bothering her. Topical potent steroids (clobetasol propionate 0.05 cream, 1×/day) and weekly intralesional infiltrations of corticosteroids (triamcinolone acetonide 10 mg/ml, Albicort®; Sanofi-Aventis) were administered with an acceptable clinical regression after 5 weeks. As her condition improved steadily, she refrained from using her crutch, and no recurrence was observed on her hand.

Bottom Line: Mycosis fungoides (MF) is the most frequent type of primary cutaneous T-cell/NK-cell lymphoma.The Koebner phenomenon is defined as the appearance of cutaneous lesions on previously noninvolved skin following trauma and is observed in a series of cutaneous diseases including psoriasis, lichen planus, viral warts, molluscum contagiosum, etc.This report suggests that some MF patients may experience Koebner phenomenon-induced MF lesions and that MF should be added to the long list of skin diseases potentially exhibiting the Koebner phenomenon.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, CHU Sart Tilman, University of Liège, Liège, Belgium.

ABSTRACT
Mycosis fungoides (MF) is the most frequent type of primary cutaneous T-cell/NK-cell lymphoma. The Koebner phenomenon is defined as the appearance of cutaneous lesions on previously noninvolved skin following trauma and is observed in a series of cutaneous diseases including psoriasis, lichen planus, viral warts, molluscum contagiosum, etc. In this case report, 3 patients with longstanding MF are presented, the 1st with the appearance of a circumscribed early-stage type MF lesion rapidly following a surgical excision of an infundibular cyst, the 2nd with the appearance of a unique unilateral palmar tumoral MF lesion at the pressure site of a crutch, and the 3rd presented localized MF early stage lesions at the friction site of a belt. This report suggests that some MF patients may experience Koebner phenomenon-induced MF lesions and that MF should be added to the long list of skin diseases potentially exhibiting the Koebner phenomenon.

No MeSH data available.


Related in: MedlinePlus