SURGICAL-MANAGEMENT OF MYCOSIS-FUNGOIDES

Mycosis fungoides (MF) is a type of cutaneous hyperproliferative T-cel l disorder that may be localized. Although there is considerable contr oversy regarding whether MF may originate as a non-neoplastic conditio n, or even whether MF is a neoplastic condition until late in its cour se, we have seen a few cases undergo what appeared to us to be a clear progression from an inflammatory disorder to MF. We now report a 32-y ear-old man with MF most prominent on his right flank and buttock who developed his patches several weeks following, and in the precise loca tions in which he had experienced, exposure to toxic chemicals in an i ndustrial accident. Because of this history, and because all lesions w ere transient except for these sites, these permanent lesions were tre ated with local surgical excision. There was no recurrence of disease at the treated sites, and the progression of MF markedly slowed follow ing surgery, although he has continued to experience multi-focal trans ient recurrent disease, controlled by a combination of topical and sys temic treatments, until the present time. Destructive methods such as excisional surgery or carbon dioxide laser may be considered a therape utic option for localized MF.