Department of Dermatology, University of Texas Medical School, TX, USA.
Int J Dermatol. 2012 Oct;51(10):1195-8. doi: 10.1111/j.1365-4632.2011.05204.x.
Mycosis fungoides (MF) and the Sézary syndrome (SS) are non-Hodgkin's lymphomas that present with cutaneous lesions. Sézary syndrome is characterized by blood involvement, exfoliative eryrthroderma, lymphadenopathy, pruritus, keratoderma, and immunosuppression. This study was to estimate the prevalence of palmoplantar keratoderma and tinea pedis in Sézary syndrome and to analyze the effectiveness of anti-fungal treatment.
We conducted a retrospective review of 1562 prospectively collected patients at the MD Anderson Cancer Center Cutaneous Lymphoma Clinic over sixteen years. All patients' palms and soles were evaluated for clinical evidence of keratoderma (hyperkeratosis) and for dermatophytosis (tinea pedis or unguum) by examining scales under 10% potassium hydroxide by light microscopy for hyphae.
Of 138 Sézary syndrome patients (88 men, 50 women, median age at diagnosis 64 years), 85 (61.6%) had palmoplantar keratoderma; 45 of the 85 Sézary syndrome patients (52.9%) also had coexisting tinea pedis. Only 14 (10.1%) had tinea pedis without keratoderma. Treatment for tinea pedis resulted in microscopy cure of keratoderma in 12 of 45 (26.7%) patients and clinical improvement.
The prevalence of palmoplantar keratoderma in Sézary syndrome is 61.6%, with co-existing tinea pedis found in 52.9%. Palmoplantar keratoderma with tinea pedis showed clinical improvement with fungicidal therapy suggesting that tinea often contributes to the pathogenesis and severity of Sézary syndrome-related keratoderma.
蕈样真菌病（MF）和 Sezary 综合征（SS）是非霍奇金淋巴瘤，表现为皮肤损伤。Sezary 综合征的特征是血液受累、剥脱性红皮病、淋巴结病、瘙痒、角化过度和免疫抑制。本研究旨在估计 Sezary 综合征中手掌足底角化过度和足癣的患病率，并分析抗真菌治疗的效果。
我们对 16 年来在 MD 安德森癌症中心皮肤科淋巴瘤诊所前瞻性收集的 1562 例患者进行了回顾性分析。所有患者的手掌和足底均通过检查 10%氢氧化钾下的鳞屑，用光学显微镜检查菌丝，评估有无角化过度（角化过度）和皮肤癣菌病（足癣或甲癣）的临床证据。
在 138 例 Sezary 综合征患者（88 名男性，50 名女性，诊断时中位年龄 64 岁）中，85 例（61.6%）有手掌足底角化过度；85 例 Sezary 综合征患者中有 45 例（52.9%）同时患有足癣。仅有 14 例（10.1%）患者患有足癣而无角化过度。治疗足癣后，45 例患者中有 12 例（26.7%）的角化过度经显微镜检查治愈，临床症状改善。
Sezary 综合征中手掌足底角化过度的患病率为 61.6%，同时伴有足癣的发生率为 52.9%。伴有足癣的手掌足底角化过度经抗真菌治疗后临床症状改善，提示足癣常与 Sezary 综合征相关角化过度的发病机制和严重程度有关。
