HYPOPIGMENTED VARIANT OF MYOSIS FUNGOIDES - DEMOGRAPHY, HISTOPATHOLOGY, AND TREATMENT OF 7 CASES

Background: Hypopigmented macules have been described infrequently as a presenting form of mycosis fungoides (MF). Objective: This study was designed to clarify general characteristics of a hypopigmented MF var iant. Methods: Seven new cases were investigated with the use of descr iptive epidemiology techniques. Demographic parameters, histopathology , and treatment outcomes were analyzed. These data were combined with those from prior reports to develop a broad composite view of this dis ease process. Results: The median ages in our series were 36 years for disease onset and 39 years at biopsy diagnosis. All patients had brow n or black skin. Histologic findings consistently showed a lack of epi dermal atrophy and moderate to profound exocytosis. Treatment with PUV A induced rapid and complete repigmentation in six of seven patients. Conclusion: On the basis of our experience and a literature review, th e hypopigmented variant of MF occurs in a younger population than typi cal forms of the disease and affects persons with dark skin almost exc lusively. Microscopic features include lack of epidermal atrophy and m oderate to extreme epidermotropism of infiltrating mononuclear cells. The treatment of choice appears to be PUVA.