Petit Thomas, Cribier Bernard, Bagot Martine, Wechsler Janine
Department of Pathology, Hôpital Henri-Mondor, 51, avenue de Lattre de Tassigny, 94010 Créteil, France.
Eur J Dermatol. 2003 Jul-Aug;13(4):410-2.
Two cases of an inflammatory vitiligo-like condition that simulated mycosis fungoides are reported. Both patients presented acquired hypopigmented macules sharply limited by an erythematous and papular border. The clinical aspect was suggestive of inflammatory vitiligo. Mycosis fungoides was suspected on skin specimens showing a dense band-like lymphocytic infiltrate with discrete nuclear atypias and marked exocytosis. This infiltrate was made of CD3 positive lymphocytes. CD8 positive lymphocytes were numerous in one case, few in the other. There was a loss of melanocytes in the lesional skin and absence of dominant T-cell clones in both cases. No repigmentation was observed after PUVA or local chemotherapy. The authors emphasized that erythematous and papular borders surrounding hypopigmented macules, CD8 positive lymphocytic infiltrate, absence of T-cell clonal rearrangement are helpful to rule out mycosis fungoides.
报告了两例类似蕈样肉芽肿的炎症性白癜风样疾病。两名患者均出现后天性色素减退斑，边界清晰，由红斑和丘疹构成。临床症状提示为炎症性白癜风。皮肤标本显示致密的带状淋巴细胞浸润，伴有散在核异型性和明显的外渗，怀疑为蕈样肉芽肿。这种浸润由CD3阳性淋巴细胞组成。一例CD8阳性淋巴细胞数量众多，另一例则较少。病变皮肤中黑素细胞缺失，两例均无优势T细胞克隆。补骨脂素加紫外线A（PUVA）或局部化疗后均未观察到色素再生。作者强调，色素减退斑周围的红斑和丘疹边界、CD8阳性淋巴细胞浸润、T细胞克隆重排的缺失有助于排除蕈样肉芽肿。
