Mycosis fungoides progression and chronic solvent exposure.
The effect of repeated exposure to specific chemicals on the initiation or progression of mycosis fungoides (MF) remains unsettled. A patient with low-grade patch stage MF progressively developed MF plaques restricted to his arms, and a tumour on his right thigh. These areas were subject to repeated exposure to solvents. His thigh was indeed in close contact with his trousers pocket where he used to store a wiping rag drenched into white spirit and cellulosic thinner. Immunophenotyping these lesions revealed a dense LCA+, CD2+, CD3+, CD4+, CD5+, CD7+, CD45+, CD45RO+ T-cell infiltrate admixed with many factor XIIIa+ dendrocytes. T-cell receptor rearrangement analysis identified a monoclonal T-cell infiltrate. An internal work-up remained negative. Stopping further solvent exposure failed to improve his condition. Oral corticotherapy combined with low-dose interferon-alpha2a halted disease progression. This observation suggests that long-term solvent exposure may trigger MF and hasten its progression from the patch stage to the plaque and tumour stages.
Nikkels
Arjen F
AF
Department of Dermatopathology, University Medical Center of Liège, Liège, Belgium. af.nikkels@chu.ulg.ac.be
Quatresooz
Pascale
P
Delvenne
Philippe
P
Balsat
Alain
A
Piérard
Gérald E
GE
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D001707:Biopsy, Needle; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology*; D016273:Occupational Exposure / Q000009:adverse effects*; D010150:Paint / Q000009:adverse effects; D010328:Patch Tests; D011994:Recombinant Proteins; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology*; D012997:Solvents / Q000009:adverse effects*; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012997:Solvents