Kaul Subuhi, Belzberg Micah, Hughes John-Douglas Matthew, Mahadevan Varun, Khanna Raveena, Bakhshi Pegah R, Hong Michael S, Williams Kyle A, Grossberg Annie L, Kwatra Shawn G, Sweren Ronald J
Department of Medicine, John H. Stroger Hospital of Cook County, Chicago, IL 60612, USA.
Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Medicines (Basel). 2019 Dec 26;7(1):1. doi: 10.3390/medicines7010001.
Mycosis fungoides (MF) is a cutaneous T-cell lymphoma. Previous reports have suggested MF is associated with inflammatory conditions such as psoriasis, increased cardiovascular risk factors as well as secondary neoplasms. A cross-sectional study of MF patients seen from 2013 to 2019 was performed. Comorbidities were selected based on the 2015 Medicare report highlighting the most common chronic medical illnesses in the United States. Lifetime comorbidity occurrence in patients with MF were compared with that in patients with atopic dermatitis, psoriasis and patients without MF. Additional analyses were performed with patients sub-stratified by race. Compared to control groups, MF was strongly associated with lymphomatoid papulosis and Hodgkin's disease, but not significantly associated with lung, breast or colon cancer. Interestingly, the association with lymphomatoid papulosis was observed in Caucasians (CI 1062-4338; < 0.001) and not African Americans ( = 0.9). Patients with MF had a greater association with congestive heart failure, hypertension (HT) and hyperlipidemia (HLD) compared with the general population. However, they were significantly less likely to have HT and HLD when compared with psoriasis patients (HT CI: 0.6-0.9; < 0.001, and HLD CI: 0.05-0.07; < 0.001). MF patients were also significantly less likely to have concomitant vitamin D deficiency compared with atopic dermatitis (AD) and psoriasis ( < 0.001). Our results suggest that the association of MF with lymphomatoid papulosis varies by race. Compared to the general population, hypertension and hyperlipidemia were positively associated with MF, however, these were significantly less likely on comparison to psoriasis. Unlike previously described, vitamin D deficiency was found to be significantly less in patients with MF.
蕈样肉芽肿（MF）是一种皮肤T细胞淋巴瘤。既往报道提示MF与银屑病等炎症性疾病、心血管危险因素增加以及继发性肿瘤有关。对2013年至2019年期间就诊的MF患者进行了一项横断面研究。根据2015年医疗保险报告中突出显示的美国最常见慢性疾病来选择合并症。将MF患者的终身合并症发生率与特应性皮炎患者、银屑病患者以及无MF患者的进行比较。还对按种族分层的患者进行了额外分析。与对照组相比，MF与淋巴瘤样丘疹病和霍奇金病密切相关，但与肺癌、乳腺癌或结肠癌无显著关联。有趣的是，在白种人中观察到与淋巴瘤样丘疹病的关联（可信区间1062 - 4338；<0.001），而在非裔美国人中未观察到（P = 0.9）。与普通人群相比，MF患者与充血性心力衰竭、高血压（HT）和高脂血症（HLD）的关联更大。然而，与银屑病患者相比，他们患HT和HLD的可能性显著降低（HT可信区间：0.6 - 0.9；<0.001，HLD可信区间：0.05 - 0.07；<0.001）。与特应性皮炎（AD）和银屑病相比，MF患者同时存在维生素D缺乏的可能性也显著降低（<0.001）。我们的结果表明，MF与淋巴瘤样丘疹病的关联因种族而异。与普通人群相比，高血压和高脂血症与MF呈正相关，然而，与银屑病相比，这些情况发生的可能性显著降低。与之前描述的不同，MF患者中维生素D缺乏的情况显著较少。
