title: Hyperpigmented mycosis fungoides: an unusual variant of cutaneous T-cell lymphoma with a frequent CD8+ phenotype.
abstract: BACKGROUND
  Hyperpigmented skin lesions rarely appear as a specific manifestation of mycosis fungoides (MF).
  
  
  OBJECTIVE
  To study the clinical, histopathological, and immunohistochemical features of hyperpigmented MF.
  
  
  METHODS
  Patients with hyperpigmented MF were identified by a file search of all patients with MF who had attended a cutaneous lymphoma outpatient clinic in the last 15 years, and the relevant data were collected.
  
  
  RESULTS
  Eight patients had early-stage MF manifested by hyperpigmented patches and/or flat plaques. All but one had a dark complexion. Mean age at diagnosis was 43 years (range, 19-69), and mean interval from disease onset to diagnosis was 6.25 years (range, 1-14). In 5 patients, the hyperpigmented lesions were the sole manifestation of the disease; in the remainder, they appeared in conjunction with other unusual lesions of MF. Histologically, all our patients had interface changes with melanophages in addition to the classical findings of early MF. Only one patient had a CD4(+) epidermotropic T-cell phenotype; 5 patients had a CD8(+) phenotype, and 2 had a CD4(-)CD8(-) phenotype. Patients received skin-targeted therapies, and all had indolent course without evidence of disease progression after a mean follow-up of 3.8 years.
  
  
  CONCLUSIONS
  This was a case series descriptive study.
  
  
  CONCLUSIONS
  Hyperpigmented MF is an atypical clinical variant of cutaneous T-cell lymphoma, with a predilection for patients with a dark complexion. It is characterized by a predominantly CD8(+) phenotype. Hyperpigmented lesions may be the sole manifestation or it may coexist with other unusual MF variants typified mostly by pigmentary changes.
authors: Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
authors: Lev
authors: L
authors: Pavlovsky
authors: Daniel
authors: D
authors: Mimouni
authors: Iris
authors: I
authors: Amitay-Laish
authors: Meora
authors: M
authors: Feinmesser
authors: Michael
authors: M
authors: David
authors: Emmilia
authors: E
authors: Hodak
mesh_terms: D000328:Adult; D000368:Aged; D016827:CD8 Antigens / Q000032:analysis*; D005260:Female; D005838:Genotype; D006801:Humans; D017495:Hyperpigmentation / Q000150:complications / Q000473:pathology*; D016410:Lymphoma, T-Cell, Cutaneous / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000276:immunology / Q000473:pathology*; D010641:Phenotype; D055815:Young Adult
chemical_list: D016827:CD8 Antigens