Lebas Eve, Arrese Jorge E, Nikkels Arjen F
Department of Dermatology, Liège University Hospital CHU, Liège, Belgium.
Dermatology. 2016;232(6):731-737. doi: 10.1159/000455944. Epub 2017 Mar 2.
Mycosis fungoides (MF) is the most frequent type of primary cutaneous natural killer and T-cell lymphoma. MF-required immunosuppressive therapies and MF-related immunosuppressive characteristics render patients with MF more prone to infections.
To describe the clinical features of cutaneous infections observed in MF patients.
A series of 56 MF patients were followed prospectively over 3 years and screened for cutaneous infections.
Prospective observational study.
Four herpes simplex virus type-I (HSV-I), 2 staphylococcal (S. aureus) impetiginizations and 2 Malassezia infections were detected in single isolated plaque/patch stage MF as well as 1 varicella zoster virus infection (herpes zoster, HZ) and 2 cases of cellulitis in 10 patients. All patients presented advanced MF. All the diagnoses were delayed due to atypical clinical presentations.
Patients with advanced MF should be particularly monitored for skin infections, especially by HSV and S. aureus. Unexplained exacerbation or the sudden appearance of oozing or ulcerations in MF lesions should initiate a search for viral or bacterial agents. Cellulitis and HZ can be severer and prolonged in MF patients.
蕈样肉芽肿(MF)是原发性皮肤自然杀伤细胞和T细胞淋巴瘤最常见的类型。MF所需的免疫抑制治疗以及MF相关的免疫抑制特征使MF患者更容易发生感染。
描述MF患者中观察到的皮肤感染的临床特征。
对56例MF患者进行了为期3年的前瞻性随访,并对皮肤感染进行筛查。
前瞻性观察研究。
在单个孤立斑块/斑片期MF患者中检测到4例单纯疱疹病毒I型(HSV-I)感染、2例葡萄球菌(金黄色葡萄球菌)脓疱病感染和2例马拉色菌感染,在10例患者中还检测到1例水痘带状疱疹病毒感染(带状疱疹,HZ)和2例蜂窝织炎。所有患者均为晚期MF。由于临床表现不典型,所有诊断均被延迟。
晚期MF患者应特别监测皮肤感染,尤其是HSV和金黄色葡萄球菌引起的感染。MF皮损中无法解释的病情加重或突然出现的渗出或溃疡应促使寻找病毒或细菌病原体。蜂窝织炎和HZ在MF患者中可能更严重且病程更长。