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Rev Alerg Mex. 2018 Jul-Sep;65(3):224-229. doi: 10.29262/ram.v65i3.335.

[Reactivation of patch-stage mycosis fungoides caused by oral administration of dialyzable leukocyte extract. Case report].

[Article in Spanish; Abstract available in Spanish from the publisher]

Author information

1
Secretaría de Salud, Hospital General de México, Ciudad de México, México. blancamorfin@hotmail.com.

Abstract

in English, Spanish

BACKGROUND:

Mycosis fungoides is a cutaneous T-cell lymphoma. The patch stage is limited to the skin and may spontaneously involute or progress, spreading to peripheral blood, lymph nodes and viscera.

CASE REPORT:

64 year-old female with a 6-year history of dermatosis with scaly, poorly delimited and pruritic plaques on the chest and extremities. She had received oral steroids and antihistamines, with transient partial remissions been experienced. Skin biopsy revealed Pautrier's microabscesses, which are pathognomonic of mycosis fungoides. Positron-emission tomography and peripheral blood smear ruled out dissemination and confirmed patch-stage mycosis fungoides. She received nitrogen mustard topical derivatives, psoralen plus UVA therapy, steroids and tacrolimus. She achieved complete remission at 6 months. Two years later, she was treated with dialyzable leukocyte extract, which reactivated the patch lesions with severe itching; the extract was discontinued. The lesions resolved two weeks after topical clobetasol was applied.

CONCLUSIONS:

Th2 predominates in mycosis fungoides. Given that dialyzable leukocyte extract reinforces the Th1 profile, it was unlikely for it to reactivate the disease, but the diversity of lymphocyte immunophenotypes in mycosis fungoides and the complex activation networks caused a paradoxical reactivation.

KEYWORDS:

Cutaneous lymphoma; Dialyzed leukocyte extract; Mycosis fungoides; Pautrier’s microabscesses

PMID:
30176209
DOI:
10.29262/ram.v65i3.335

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