Cutaneous malignant melanoma appearing during photochemotherapy of mycosis fungoides.
We report a case of malignant melanoma that appeared in a 56-year-old man with mycosis fungoides (stage Ia) during treatment with PUVA. The cumulative UVA dose was 1,177 J/cm2. The pigmented lesion was removed and PUVA therapy discontinued. Histological examination revealed a superficial spreading malignant melanoma (1.77 mm thick, Clark level IV). The delayed-type cutaneous hypersensitivity was studied. The presence of a second malignancy after mycosis fungoides and PUVA therapy may have been coincidental. Nevertheless, this case suggests that the immunosuppression induced by mycosis fungoides and by PUVA therapy might be a pathogenetic factor in the development of malignant melanoma.
Reseghetti
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Università degli Studi di Milano, Italia.
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D006801:Humans; D008297:Male; D008545:Melanoma / Q000209:etiology*; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000188:drug therapy*; D016609:Neoplasms, Second Primary / Q000209:etiology*; D011701:PUVA Therapy / Q000009:adverse effects*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000209:etiology*