Dupin M, Darie H, Jumbou O, Veran Y, Gros P, Dreno B, Dormont D, Millet P
Clinique de Dermatologie, Hôpital d'Instruction des Armées Begin, Saint-Mandé.
Ann Dermatol Venereol. 1995;122(9):595-8.
The pathophysiology of mycosis fungoides remains uncertain but HTLV I or a similar virus could be involved. We observed a couple who developed mycosis fungoides suggesting the infectious hypothesis might indeed be valid.
A 70-year-old man who had often travelled in foreign countries developed parapsoriasis en plaques, lymphomatoid papulosis and mycosis fungoides successively over a thirty year period. Several years after the first manifestation of mycosis fungoides, his wife also developed a single plaque of mycosis fungoides. The diagnosis was confirmed on pathology slides and immunohistochemistry tests as well as on the basis of T-receptor gene rearrangement in both patients. Search for HTLV I was negative using serology tests and PCR on circulating lymphocytes.
The epidemiological situation in our observation (several trips in foreign countries and the delayed development of mycosis fungoides in the wife) favours the hypothesis of an infectious mechanism. Search for HTLV I was unsuccessful with classical virology methods. Certain recent work suggests a virus similar but different from the HTLV I virus could be involved in the pathogenesis of mycosis fungoides.
蕈样肉芽肿的病理生理学仍不明确,但人类嗜T淋巴细胞病毒I型(HTLV I)或类似病毒可能与之相关。我们观察到一对夫妇先后患上了蕈样肉芽肿,这表明感染假说可能确实成立。
一名70岁的男子经常出国旅行,在30年的时间里先后患上了斑块状副银屑病、淋巴瘤样丘疹病和蕈样肉芽肿。在蕈样肉芽肿首次出现数年之后,他的妻子也患上了一块蕈样肉芽肿。通过病理切片、免疫组织化学检测以及两位患者的T细胞受体基因重排,确诊了病情。采用血清学检测和循环淋巴细胞的聚合酶链反应(PCR)对HTLV I进行检测,结果为阴性。
我们观察中的流行病学情况(多次出国旅行以及妻子蕈样肉芽肿的延迟发病)支持感染机制假说。采用经典病毒学方法未能成功检测到HTLV I。最近的一些研究表明,一种与HTLV I病毒相似但不同的病毒可能参与了蕈样肉芽肿的发病机制。