Mimouni D, David M, Feinmesser M, Coire C I, Hodak E
Department of Dermatology, Rabin Medical Centre, Petah Tikva, Israel.
Br J Dermatol. 2001 Dec;145(6):1008-14. doi: 10.1046/j.1365-2133.2001.04530.x.
We describe four patients with mycosis fungoides (MF) in whom depigmentation, and also leucotrichia in one, occurred following the resolution of the eruption during phototherapy (psoralen plus ultraviolet A treatment in three patients, climatotherapy in one). In all cases, the depigmentation was localized to the area of the pre-existing MF lesions. There was no clinically obvious phototoxicity. Biopsy study including S100 staining in all cases, and electron microscopy in one case, demonstrated the total absence of melanocytes, with no evidence of MF. It is suggested that the phototherapy may have activated a cell-mediated immunity leading to destruction of the melanocytes. We recommend that vitiligo-like leucoderma be added to the list of untoward effects of phototherapy in MF.
我们描述了4例蕈样肉芽肿（MF）患者，在光疗（3例采用补骨脂素加紫外线A治疗，1例采用气候疗法）期间皮疹消退后出现了色素脱失，其中1例还出现了白发。在所有病例中，色素脱失均局限于先前MF皮损的区域。临床上没有明显的光毒性。所有病例均进行了包括S100染色的活检研究，1例进行了电子显微镜检查，结果显示完全没有黑素细胞，也没有MF的证据。提示光疗可能激活了细胞介导的免疫反应，导致黑素细胞被破坏。我们建议将白癜风样白斑添加到MF光疗的不良反应列表中。
