Bullous mycosis fungoides: Report of a case complicated by Kaposi's varicelliform eruption

Vesiculobullous eruptions in mycosis fungoides (MF) are extremely rare. Here, we report a case of a 62‐year‐old woman presenting with erythematous patches and plaques of 2 years in duration, who had recently developed vesicles on erythematous MF plaques. Histopathological examination showed intra‐su...

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Vydané v:	Journal of dermatology Ročník 40; číslo 10; s. 844 - 847
Hlavní autori:	Xu, Xiu-Lian, Huang, Ying-Xue, Lin, Lin, Zhang, Meng-Li, Jiang, Yi-Qun, Sun, Jian-Fang
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	England Blackwell Publishing Ltd 01.10.2013 Wiley Subscription Services, Inc
Predmet:	bullous CD4 antigen Female Herpes simplex virus Humans immunohistochemistry Kaposi Varicelliform Eruption - complications Kaposi Varicelliform Eruption - pathology Kaposi's varicelliform Middle Aged mycosis fungoides Mycosis Fungoides - complications Mycosis Fungoides - pathology Skin - pathology immunohistochemistry bullous Kaposi's varicelliform mycosis fungoides
ISSN:	0385-2407, 1346-8138, 1346-8138
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Abstract	Vesiculobullous eruptions in mycosis fungoides (MF) are extremely rare. Here, we report a case of a 62‐year‐old woman presenting with erythematous patches and plaques of 2 years in duration, who had recently developed vesicles on erythematous MF plaques. Histopathological examination showed intra‐subepidermal blisters, and infiltration of the epidermis by atypical lymphoid cells, forming Pautrier's microabscesses. Negative immunofluorescence excluded autoimmune blistering diseases. Immunohistochemistry revealed a CD4+ T‐cell phenotype and gene rearrangement study confirmed a clonal T‐cell proliferation. Kaposi's varicelliform eruption (KVE) developed in the patient 1 week after initiation of systemic corticosteroids and immunotherapy. Cluster of vesicles and erosions arising on the pre‐existing plaque and a positive immunofluorescence test for Herpes simplex virus and histopathological examination confirmed the diagnosis of cutaneous herpes infection. This is the first case report on bullous MF complicated by KVE in the published work.
AbstractList	Vesiculobullous eruptions in mycosis fungoides (MF) are extremely rare. Here, we report a case of a 62-year-old woman presenting with erythematous patches and plaques of 2 years in duration, who had recently developed vesicles on erythematous MF plaques. Histopathological examination showed intra-subepidermal blisters, and infiltration of the epidermis by atypical lymphoid cells, forming Pautrier's microabscesses. Negative immunofluorescence excluded autoimmune blistering diseases. Immunohistochemistry revealed a CD4+ T-cell phenotype and gene rearrangement study confirmed a clonal T-cell proliferation. Kaposi's varicelliform eruption (KVE) developed in the patient 1 week after initiation of systemic corticosteroids and immunotherapy. Cluster of vesicles and erosions arising on the pre-existing plaque and a positive immunofluorescence test for Herpes simplex virus and histopathological examination confirmed the diagnosis of cutaneous herpes infection. This is the first case report on bullous MF complicated by KVE in the published work. [PUBLICATION ABSTRACT] Vesiculobullous eruptions in mycosis fungoides (MF) are extremely rare. Here, we report a case of a 62-year-old woman presenting with erythematous patches and plaques of 2 years in duration, who had recently developed vesicles on erythematous MF plaques. Histopathological examination showed intra-subepidermal blisters, and infiltration of the epidermis by atypical lymphoid cells, forming Pautrier's microabscesses. Negative immunofluorescence excluded autoimmune blistering diseases. Immunohistochemistry revealed a CD4+ T-cell phenotype and gene rearrangement study confirmed a clonal T-cell proliferation. Kaposi's varicelliform eruption (KVE) developed in the patient 1 week after initiation of systemic corticosteroids and immunotherapy. Cluster of vesicles and erosions arising on the pre-existing plaque and a positive immunofluorescence test for Herpes simplex virus and histopathological examination confirmed the diagnosis of cutaneous herpes infection. This is the first case report on bullous MF complicated by KVE in the published work. Vesiculobullous eruptions in mycosis fungoides (MF) are extremely rare. Here, we report a case of a 62‐year‐old woman presenting with erythematous patches and plaques of 2 years in duration, who had recently developed vesicles on erythematous MF plaques. Histopathological examination showed intra‐subepidermal blisters, and infiltration of the epidermis by atypical lymphoid cells, forming Pautrier's microabscesses. Negative immunofluorescence excluded autoimmune blistering diseases. Immunohistochemistry revealed a CD4+ T‐cell phenotype and gene rearrangement study confirmed a clonal T‐cell proliferation. Kaposi's varicelliform eruption (KVE) developed in the patient 1 week after initiation of systemic corticosteroids and immunotherapy. Cluster of vesicles and erosions arising on the pre‐existing plaque and a positive immunofluorescence test for Herpes simplex virus and histopathological examination confirmed the diagnosis of cutaneous herpes infection. This is the first case report on bullous MF complicated by KVE in the published work. Vesiculobullous eruptions in mycosis fungoides (MF) are extremely rare. Here, we report a case of a 62-year-old woman presenting with erythematous patches and plaques of 2 years in duration, who had recently developed vesicles on erythematous MF plaques. Histopathological examination showed intra-subepidermal blisters, and infiltration of the epidermis by atypical lymphoid cells, forming Pautrier's microabscesses. Negative immunofluorescence excluded autoimmune blistering diseases. Immunohistochemistry revealed a CD4⁺ T-cell phenotype and gene rearrangement study confirmed a clonal T-cell proliferation. Kaposi's varicelliform eruption (KVE) developed in the patient 1 week after initiation of systemic corticosteroids and immunotherapy. Cluster of vesicles and erosions arising on the pre-existing plaque and a positive immunofluorescence test for Herpes simplex virus and histopathological examination confirmed the diagnosis of cutaneous herpes infection. This is the first case report on bullous MF complicated by KVE in the published work.Vesiculobullous eruptions in mycosis fungoides (MF) are extremely rare. Here, we report a case of a 62-year-old woman presenting with erythematous patches and plaques of 2 years in duration, who had recently developed vesicles on erythematous MF plaques. Histopathological examination showed intra-subepidermal blisters, and infiltration of the epidermis by atypical lymphoid cells, forming Pautrier's microabscesses. Negative immunofluorescence excluded autoimmune blistering diseases. Immunohistochemistry revealed a CD4⁺ T-cell phenotype and gene rearrangement study confirmed a clonal T-cell proliferation. Kaposi's varicelliform eruption (KVE) developed in the patient 1 week after initiation of systemic corticosteroids and immunotherapy. Cluster of vesicles and erosions arising on the pre-existing plaque and a positive immunofluorescence test for Herpes simplex virus and histopathological examination confirmed the diagnosis of cutaneous herpes infection. This is the first case report on bullous MF complicated by KVE in the published work. Vesiculobullous eruptions in mycosis fungoides (MF) are extremely rare. Here, we report a case of a 62-year-old woman presenting with erythematous patches and plaques of 2 years in duration, who had recently developed vesicles on erythematous MF plaques. Histopathological examination showed intra-subepidermal blisters, and infiltration of the epidermis by atypical lymphoid cells, forming Pautrier's microabscesses. Negative immunofluorescence excluded autoimmune blistering diseases. Immunohistochemistry revealed a CD4⁺ T-cell phenotype and gene rearrangement study confirmed a clonal T-cell proliferation. Kaposi's varicelliform eruption (KVE) developed in the patient 1 week after initiation of systemic corticosteroids and immunotherapy. Cluster of vesicles and erosions arising on the pre-existing plaque and a positive immunofluorescence test for Herpes simplex virus and histopathological examination confirmed the diagnosis of cutaneous herpes infection. This is the first case report on bullous MF complicated by KVE in the published work.
Author	Huang, Ying-Xue Sun, Jian-Fang Xu, Xiu-Lian Lin, Lin Zhang, Meng-Li Jiang, Yi-Qun
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References	Sarnoff DS, DeFeo CP. Coexistence of pemphigus foliaceus and mycosis fungoides. Arch Dermatol 1985; 121: 669-672. Goday JJ, Aguirre A, Raton JA, Diaz-Perez JL. Local bullous reaction to topical mechlorethamine (mustine). Contact Dermatitis 1990; 22: 306-307. Patterson JW, Ali M, Murray JC, Hazra TA. Bullous pemphigoid. Occurrence in a patient with mycosis fungoides receiving puva and topical nitrogen mustard therapy. Int J Dermatol 1985; 24: 173-176. Turner CC, Assaad D, Shear NH. Bullae on the legs of an elderly man. Mycosis fungoides bullosa. Arch Dermatol 1994; 130: 1551-1552, 1554-1555. Bowman PH, Hogan DJ, Sanusi ID. Mycosis fungoides bullosa: report of a case and review of the literature. J Am Acad Dermatol 2001; 45: 934-839. Garb J, Wise F. Mycosis fungoides with bullous lesions: report of a case resistant to roentgen and arsenical therapy; effects of empiric therapy, partly based on laboratory investigations. Arch Derm Syphilol 1943; 48: 359-368. Hayashi S, Yamada Y, Dekio S, Jidoi J. Kaposi's varicelliform eruption in a patient with mycosis fungoides. Clin Exp Dermatol 1997; 22: 41-43. Pullmann H, Trost T, Witte U. Acral bullae following puva-therapy (author's transl). Z Hautkr 1982; 57: 288-293. McBride SR, Dahl MG, Slater DN, Sviland L. Vesicular mycosis fungoides. Br J Dermatol 1998; 138: 141-144. Desai KR, Pezner RD, Lipsett JA et al. Total skin electron irradiation for mycosis fungoides: relationship between acute toxicities and measured dose at different anatomic sites. Int J Radiat Oncol Biol Phys 1988; 15: 641-645. Ueda C, Makino T, Asano Y, Watanabe H, Hanakawa H, Shimizu T. An ultrastructural examination of a blistering lesion of mycosis fungoides bullosa. Br J Dermatol 2011; 165: 213-214. Fleischmann M, Celerier P, Bernard P, Litoux P, Dreno B. Long-term interferon-alpha therapy induces autoantibodies against epidermis. Dermatology 1996; 192: 50-55. Gahlen-Schulte S, Sterry W, Runne U. Generalized cutaneous herpes infection in mycosis fungoides (Kaposi's varicelliform eruption). Z Hautkr 1982; 57: 1757-1765. Segal RJ, Watson W. Kaposi's varicelliform eruption in mycosis fungoides. Arch Dermatol 1978; 114: 1067-1069. Kaposi M. "Mycosis fungoides" und ihre beziehungen zu anderen ahnlichen erkrankungsformen. Wien Med Wochenschr 1887; 19: 22-37. 1982; 57 1990; 22 1997; 22 1994; 130 1988; 15 1943; 48 1996; 192 1978; 114 1998; 138 2001; 45 1887; 19 1985; 121 1985; 24 2011; 165
References_xml	– reference: Segal RJ, Watson W. Kaposi's varicelliform eruption in mycosis fungoides. Arch Dermatol 1978; 114: 1067-1069. – reference: Pullmann H, Trost T, Witte U. Acral bullae following puva-therapy (author's transl). Z Hautkr 1982; 57: 288-293. – reference: Ueda C, Makino T, Asano Y, Watanabe H, Hanakawa H, Shimizu T. An ultrastructural examination of a blistering lesion of mycosis fungoides bullosa. Br J Dermatol 2011; 165: 213-214. – reference: Sarnoff DS, DeFeo CP. Coexistence of pemphigus foliaceus and mycosis fungoides. Arch Dermatol 1985; 121: 669-672. – reference: Patterson JW, Ali M, Murray JC, Hazra TA. Bullous pemphigoid. Occurrence in a patient with mycosis fungoides receiving puva and topical nitrogen mustard therapy. Int J Dermatol 1985; 24: 173-176. – reference: Kaposi M. "Mycosis fungoides" und ihre beziehungen zu anderen ahnlichen erkrankungsformen. Wien Med Wochenschr 1887; 19: 22-37. – reference: McBride SR, Dahl MG, Slater DN, Sviland L. Vesicular mycosis fungoides. Br J Dermatol 1998; 138: 141-144. – reference: Bowman PH, Hogan DJ, Sanusi ID. Mycosis fungoides bullosa: report of a case and review of the literature. J Am Acad Dermatol 2001; 45: 934-839. – reference: Garb J, Wise F. Mycosis fungoides with bullous lesions: report of a case resistant to roentgen and arsenical therapy; effects of empiric therapy, partly based on laboratory investigations. Arch Derm Syphilol 1943; 48: 359-368. – reference: Turner CC, Assaad D, Shear NH. Bullae on the legs of an elderly man. Mycosis fungoides bullosa. Arch Dermatol 1994; 130: 1551-1552, 1554-1555. – reference: Fleischmann M, Celerier P, Bernard P, Litoux P, Dreno B. Long-term interferon-alpha therapy induces autoantibodies against epidermis. Dermatology 1996; 192: 50-55. – reference: Desai KR, Pezner RD, Lipsett JA et al. Total skin electron irradiation for mycosis fungoides: relationship between acute toxicities and measured dose at different anatomic sites. Int J Radiat Oncol Biol Phys 1988; 15: 641-645. – reference: Gahlen-Schulte S, Sterry W, Runne U. Generalized cutaneous herpes infection in mycosis fungoides (Kaposi's varicelliform eruption). Z Hautkr 1982; 57: 1757-1765. – reference: Hayashi S, Yamada Y, Dekio S, Jidoi J. Kaposi's varicelliform eruption in a patient with mycosis fungoides. Clin Exp Dermatol 1997; 22: 41-43. – reference: Goday JJ, Aguirre A, Raton JA, Diaz-Perez JL. Local bullous reaction to topical mechlorethamine (mustine). Contact Dermatitis 1990; 22: 306-307. – volume: 192 start-page: 50 year: 1996 end-page: 55 article-title: Long‐term interferon‐alpha therapy induces autoantibodies against epidermis publication-title: Dermatology – volume: 138 start-page: 141 year: 1998 end-page: 144 article-title: Vesicular mycosis fungoides publication-title: Br J Dermatol – volume: 57 start-page: 1757 year: 1982 end-page: 1765 article-title: Generalized cutaneous herpes infection in mycosis fungoides (Kaposi's varicelliform eruption) publication-title: Z Hautkr – volume: 121 start-page: 669 year: 1985 end-page: 672 article-title: Coexistence of pemphigus foliaceus and mycosis fungoides publication-title: Arch Dermatol – volume: 114 start-page: 1067 year: 1978 end-page: 1069 article-title: Kaposi's varicelliform eruption in mycosis fungoides publication-title: Arch Dermatol – volume: 165 start-page: 213 year: 2011 end-page: 214 article-title: An ultrastructural examination of a blistering lesion of mycosis fungoides bullosa publication-title: Br J Dermatol – volume: 48 start-page: 359 year: 1943 end-page: 368 article-title: Mycosis fungoides with bullous lesions: report of a case resistant to roentgen and arsenical therapy; effects of empiric therapy, partly based on laboratory investigations publication-title: Arch Derm Syphilol – volume: 24 start-page: 173 year: 1985 end-page: 176 article-title: Bullous pemphigoid. Occurrence in a patient with mycosis fungoides receiving puva and topical nitrogen mustard therapy publication-title: Int J Dermatol – volume: 22 start-page: 306 year: 1990 end-page: 307 article-title: Local bullous reaction to topical mechlorethamine (mustine) publication-title: Contact Dermatitis – volume: 57 start-page: 288 year: 1982 end-page: 293 article-title: Acral bullae following puva‐therapy (author's transl) publication-title: Z Hautkr – volume: 15 start-page: 641 year: 1988 end-page: 645 article-title: Total skin electron irradiation for mycosis fungoides: relationship between acute toxicities and measured dose at different anatomic sites publication-title: Int J Radiat Oncol Biol Phys – volume: 45 start-page: 934 year: 2001 end-page: 839 article-title: Mycosis fungoides bullosa: report of a case and review of the literature publication-title: J Am Acad Dermatol – volume: 22 start-page: 41 year: 1997 end-page: 43 article-title: Kaposi's varicelliform eruption in a patient with mycosis fungoides publication-title: Clin Exp Dermatol – volume: 19 start-page: 22 year: 1887 end-page: 37 article-title: “Mycosis fungoides” und ihre beziehungen zu anderen ahnlichen erkrankungsformen publication-title: Wien Med Wochenschr – volume: 130 start-page: 1551 year: 1994 end-page: 1552 article-title: Bullae on the legs of an elderly man. Mycosis fungoides bullosa publication-title: Arch Dermatol
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Snippet	Vesiculobullous eruptions in mycosis fungoides (MF) are extremely rare. Here, we report a case of a 62‐year‐old woman presenting with erythematous patches and... Vesiculobullous eruptions in mycosis fungoides (MF) are extremely rare. Here, we report a case of a 62-year-old woman presenting with erythematous patches and...
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Title	Bullous mycosis fungoides: Report of a case complicated by Kaposi's varicelliform eruption
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