clobetasol and Skin-Neoplasms

Pagetoid reticulosis (PR) is a rare lymphoproliferative disorder with indolent behavior considered a variant of mycosis fungoides. It is characterized by marked epidermotropism of the neoplastic lymphocytes. Since its original description, five cases have been reported in children. We report a new case of PR with an immunohistochemical profile not previously described in children.

Topics: Administration, Topical; Adolescent; Biopsy; Child; Child, Preschool; Clobetasol; Female; Glucocorticoids; Humans; Immunohistochemistry; Immunophenotyping; Lymphocytes; Lymphoproliferative Disorders; Male; Mycosis Fungoides; Pagetoid Reticulosis; Skin; Skin Neoplasms; Treatment Outcome

Mycosis fungoids can present with various clinical and histological features, with only a few of them being recognized as distinct entities in the current WHO and EORTC classifications. Histologically, mycosis fungoids (MF) usually show a superficial perivascular or band-like lymphocytic infiltrate with epidermotropism. We here report two cases of a rare histological variant of MF, called interstitial in the literature. Our first patient, a 71-year-old male, had a previously diagnosed MF, which clinically evolved towards nodules, showing histologically an interstitial lymphocytic infiltrate without epidermotropism and without large cell transformation. The second patient was a 64-year-old female with widespread plaques and nodules. Histologically, a dense dermal interstitial infiltrate was observed, with foci of epidermotropism, without large cell transformation. At relapse after treatment, she presented with plaques, papules and nodules, histologically showing a slight interstitial lymphocytic infiltrate that resembled granuloma annulare or inflammatory morphea. In both patients, clinical aspect suggested MF and a dominant T-cell clone was found in lesional skin. Nodules in MF are not always the hallmark of large cell transformation, but may correspond to unusual interstitial lesions. Diagnosis of such rare variant may be difficult and requires a good clinical pathological correlation together with the search for foci of epidermotropism on skin biopsy and for a dominant cutaneous T-cell clone.

Topics: Aged; Anti-Inflammatory Agents; Antirheumatic Agents; Arthritis, Rheumatoid; Biopsy; Clobetasol; Female; Humans; Immunophenotyping; Male; Methotrexate; Middle Aged; Mycosis Fungoides; Neoplasm Recurrence, Local; PUVA Therapy; Skin Neoplasms; T-Lymphocyte Subsets

Superficial cutaneous hemangiomas of infancy represent a therapeutic challenge. Two small case series using ultrapotent topical corticosteroids for periocular hemangiomas were reported in the ophthalmologic literature. The use of this therapy for hemangiomas of infancy at other sites on the body has not been reported.. We sought to assess the clinical effects of short-term application of ultrapotent topical corticosteroids for the treatment of hemangiomas of infancy.. The records of 34 infants with proliferating hemangiomas of infancy that were treated with ultrapotent topical steroids were reviewed retrospectively. Treatment response was based on: (1) cessation of growth; (2) shrinkage or flattening of the lesion; and (3) lightening of the surface color. Lesions demonstrating responses of two of the three criteria were judged to have good response; one criterion, partial response; and no improvement, no response.. Of the patients, 35% demonstrated good response, 38% partial response, and 27% no response.. Hemangiomas in 74% of the infants demonstrated either good or partial response to treatment with ultrapotent topical corticosteroids. Of the responders, the majority reported cessation of growth before what would have been expected for their age. Improvement varied, with thinner superficial hemangiomas demonstrating better cosmetic improvement than thicker lesions.

Topics: Administration, Cutaneous; Betamethasone; Clobetasol; Extremities; Eye Neoplasms; Eyelids; Facial Neoplasms; Female; Hemangioma; Humans; Infant; Infant, Newborn; Male; Retrospective Studies; Skin Neoplasms; Treatment Outcome

Topics: Administration, Topical; Adult; Biopsy, Needle; Child; Clobetasol; Female; Hospitals, University; Humans; Male; Middle Aged; Mycosis Fungoides; Neoplasm Staging; Photopheresis; Prognosis; PUVA Therapy; Radiotherapy; San Francisco; Sezary Syndrome; Skin Neoplasms; Treatment Outcome; Ultraviolet Therapy

A double-blind, randomized, placebo-controlled trial was carried out comparing the effects of clobetasol propionate ointment and the ointment base on the inflammation induced by cryotherapy of basal cell carcinomata and warts. A single application of the steroid was shown to be significantly better at reducing erythema, pain and swelling than the ointment base.

Topics: Adolescent; Adult; Aged; Betamethasone; Carcinoma, Basal Cell; Clinical Trials as Topic; Clobetasol; Cryosurgery; Dermatitis; Double-Blind Method; Erythema; Humans; Middle Aged; Ointments; Skin Diseases; Skin Neoplasms; Warts

Topics: Administration, Cutaneous; Aged; Biomarkers, Tumor; Biopsy; Clobetasol; Humans; Ichthyosis; Immunohistochemistry; Male; Mycosis Fungoides; Ointments; Skin; Skin Neoplasms; Treatment Outcome

Topics: Alopecia; Antineoplastic Agents, Immunological; Clobetasol; Female; Glucocorticoids; Hair Color; Humans; Melanoma; Middle Aged; Molecular Targeted Therapy; Protein Kinase Inhibitors; Skin Neoplasms; Treatment Outcome

Topics: Aged, 80 and over; Anti-Inflammatory Agents; Carcinoma, Basal Cell; Clobetasol; Dermatologic Agents; Facial Neoplasms; Humans; Male; Postoperative Complications; Scalp Dermatoses; Skin Neoplasms; Skin Transplantation

Lymphomatoid papulosis (LyP) is a benign skin condition that typically presents with grouped or scattered lesions on the body that self-resolve within weeks or months of onset. LyP belongs to the group of CD30-positive lymphoproliferative disorders. Several histological variants of LyP exist, and the histological features of LyP can overlap with other lymphoproliferative disorders; therefore, both histological and clinical correlations are needed for a proper diagnosis of LyP. We report an unusual case of LyP displaying a T follicular helper cell-like phenotype and histopathologically resembling the primary cutaneous CD4-positive small-sized to medium-sized T-cell lymphoproliferative disorder.

Topics: Clobetasol; Glucocorticoids; Humans; Lymphomatoid Papulosis; Male; Middle Aged; Neoplasms, Multiple Primary; Phenotype; Skin Neoplasms; T Follicular Helper Cells

Topical superpotent class I corticosteroids (CSs) are highly effective in the treatment of early-stage mycosis fungoides (MF) and are readily available, easily applied, and have minor side effects compared to other topical therapeutic options. Because MF is a chronic disease, prolonged treatment is needed, raising the concern of CS-induced cutaneous adverse effects (AEs). In this observational study, we aimed to evaluate the risk for skin AEs of clobetasol propionate cream 0.05% in patients with early-stage MF. Thirteen consecutive patients with MF were treated with clobetasol propionate cream 0.05% once or twice daily as monotherapy and were followed for 4 to 17 months. One participant was lost to follow-up, and the remaining 12 participants responded to treatment with topical clobetasol propionate with minimal side effects. With proper education and monitoring, topical CSs are a safe and effective mainstay of treatment for patches and flat plaques in patients with early-stage localized MF.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Atrophy; Clobetasol; Female; Glucocorticoids; Humans; Hypopigmentation; Male; Middle Aged; Mycosis Fungoides; Prospective Studies; Skin; Skin Cream; Skin Neoplasms

Lymphomatoid papulosis (LyP) is a chronic skin condition, characterized by recurrent eruptions of papules and nodules with or without central necrosis that spontaneously resolve. This condition was originally described by Macaulay in 1968 as a self-healing rhythmical paradoxical eruption that was clinically benign yet histologically malignant.1 Clinically, it is defined by papules that wax and wane, are generally less than 1cm in diameter, and heal spontaneously after 6–8 weeks with subsequent scarring.2

Topics: Administration, Cutaneous; Adult; Clobetasol; Diagnosis, Differential; Female; Humans; Leg; Lymphomatoid Papulosis; Skin Neoplasms; T-Lymphocyte Subsets

Topics: Aged; Anal Canal; Anti-Inflammatory Agents; Antineoplastic Agents, Immunological; Clobetasol; Female; Humans; Melanoma; Nivolumab; Perineum; Skin Neoplasms; Vulvar Lichen Sclerosus

Topics: Administration, Cutaneous; Aged; Anti-Bacterial Agents; Anti-Inflammatory Agents; Biopsy; Clobetasol; Diagnosis, Differential; Fusidic Acid; Humans; Male; Scalp Dermatoses; Skin Diseases, Vesiculobullous; Skin Neoplasms

The cosmetic use of bleaching products is common among women from sub-Saharan Africa. The most frequently used products are highly potent corticosteroids (clobetasol propionate) and hydroquinone. Herein, we report 8 cases of SCC in women using skin bleaching products for cosmetic purposes. Our aim is to describe the epidemiological, clinical and pathological aspects of the carcinomas observed during the course of skin lightening.. We conducted a descriptive multicentre study from August 2005 to January 2016 in three dermatology units in Senegal. We included all patients consulting for cutaneous squamous cell carcinoma associated with skin bleaching. Sociodemographic, clinical, paraclinical and therapeutic data were recorded.. A total of 8 female patients were included. The mean age was 48.1 years (37-63 years). Topical hydroquinone and highly potent corticosteroids were the main products used over the whole body, for an average duration of 20.3 years. No pre-neoplastic skin disease was found in our patients. The clinical aspects of tumours were as follows: cauliflower-like (n=4), ulcerated (n=3) and nodular (n=1). The average development time before consultation was 6.75 months. All the cutaneous squamous cell carcinomas were localized to lichenoid lesions or exogenous ochronotic lesions on photo-exposed areas: face (n=1), neck (n=3) or upper back (n=4). The most common histopathological type was the infiltrating form and there was one case of in situ carcinoma. The outcome was favourable in six of eight patients after surgical resection. Two deaths occurred: one through tumour recurrence and the other through haemorrhagic shock.. From 2005 to 2016, eight cases of cutaneous squamous cell carcinomas associated with cosmetic use of bleaching products were reported in Senegal. The mechanism was not fully elucidated and further studies are necessary. These observations provide an additional argument for combating this practice and including skin bleaching among known risk factors for squamous cell carcinoma.

Topics: Adult; Back; Carcinoma in Situ; Carcinoma, Squamous Cell; Clobetasol; Face; Female; Humans; Hydroquinones; Middle Aged; Neoplasm Recurrence, Local; Senegal; Shock, Hemorrhagic; Skin Lightening Preparations; Skin Neoplasms

Topics: Administration, Oral; Administration, Topical; Aged, 80 and over; Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Biopsy; Clobetasol; Drug Therapy, Combination; Female; Humans; Leg Dermatoses; Lymphatic Metastasis; Melanoma; Neoplasm Metastasis; Neoplasm Staging; Pemphigoid, Bullous; Prednisone; Skin; Skin Neoplasms

Lymphomatoid papulosis is often regarded as a low-grade variant of cutaneous T cell lymphoma (CTCL). Given the excellent long-term prognosis, recent consensus guidelines indicate that patients can be monitored off therapy. We report a case of a 67-year-old man who presented with lymphomatoid papulosis, with necrotic papules that have been intermittently present for over forty years.

Topics: Aged; Clobetasol; Glucocorticoids; Humans; Hydroquinones; Hyperpigmentation; Lymphomatoid Papulosis; Male; Skin Neoplasms; Watchful Waiting

Iatrogenic Kaposi sarcoma (KS) has previously been reported in patients with bullous pemphigoid (BP), in relation to systemic steroids. To report three cases of previously unreported cutaneous KS during treatment with superpotent topical steroids (STS) and methotrexate (MTX). All patients were elderly men with BP treated with STS for 2 to 32 months (cumulative doses: 2,700-9,150 g) before MTX was introduced (dosage: 10-12.5 mg/week). KS occurred one to nine months after the combined therapy. In one case, KS rapidly resolved after withdrawal of MTX. In two cases, vinblastine and/or radiotherapy were required to achieve regression of KS. Human herpes virus 8 (HHV8) latency-associated nuclear antigen was not expressed in BP lesions biopsied prior to development of KS (n = 3), but HHV8 DNA was detected in BP lesions from the patient with the most aggressive KS. Several predisposing factors were identified, including sex and age, high cumulative doses of STS, combination with MTX, and impaired immune status. In such cases, serum antibodies against HHV8 infection may be investigated in BP patients before introduction of MTX in order to guide clinical monitoring.

Topics: Administration, Cutaneous; Aged; Clobetasol; Drug Therapy, Combination; Humans; Immunosuppressive Agents; Male; Methotrexate; Pemphigoid, Bullous; Sarcoma, Kaposi; Skin Neoplasms

Hypopigmented mycosis fungoides (HMF) is the most common variant of mycosis fungoides (MF) in children. Large-cell transformation in HMF has never been reported. Herein we report a case of HMF in an 8-year-old boy who presented with a 6-year history of hypopigmented patches on the bilateral arms, lower back, buttocks, posterior thighs, and lower legs. Biopsy revealed an abnormal CD8

Topics: Biopsy; Cell Transformation, Neoplastic; Child; Clobetasol; Glucocorticoids; Humans; Hypopigmentation; Male; Mycosis Fungoides; Skin; Skin Neoplasms; T-Lymphocytes; Ultraviolet Therapy

Clear cell acanthoma is a rare, epidermal tumor not common in the area of the nipples; indeed, the literature describes only 8 cases, all showing unilateral presentation. We here report the first case of bilateral clear cell acanthoma with good response to topical corticosteroids.. A sixteen-year old girl presented with 2 excrescent, fleshy, and exudative tumor masses in both nipples and areola mammae. A biopsy was conducted and confirmed clear cell acanthoma histopathologically. Treatment with strong corticosteroids resulted in rapid improvement and resolution. After one year of follow-up, the patient developed atopic dermatitis.. We describe the first case of bilateral clear cell acanthoma localized in the nipple/areola that resolved with powerful corticosteroids, suggesting a reactive etiology of the lesion.

Topics: Acanthoma; Administration, Topical; Adolescent; Biopsy; Clobetasol; Female; Glucocorticoids; Humans; Neoplasms, Multiple Primary; Nipples; Skin Neoplasms; Treatment Outcome

Topics: Administration, Cutaneous; Aged; Aminoquinolines; Antineoplastic Agents; Bowen's Disease; CD3 Complex; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Clobetasol; Drug Administration Schedule; Drug Therapy, Combination; Follow-Up Studies; Forkhead Transcription Factors; Glucocorticoids; Humans; Imiquimod; Ointments; Skin Neoplasms; T-Lymphocytes, Regulatory; Treatment Outcome

We report the case of a 59-year-old woman with type A regional lymphomatoid papulosis (LyP) that was localized to the left breast, a cutaneous area that had received radiotherapy for treatment of a carcinoma of the breast 5 years prior. This report is a rare example of regional LyP with all lesions located in an area of prior radiotherapy.

Topics: Biopsy; Breast; Breast Neoplasms; Clobetasol; Dermatologic Agents; Diagnosis, Differential; Female; Humans; Lymphomatoid Papulosis; Methotrexate; Middle Aged; Skin; Skin Neoplasms; Treatment Outcome

Topics: Alopecia; Anti-Inflammatory Agents; Antineoplastic Agents; Clobetasol; Female; Hair Follicle; Humans; Indoles; Male; Melanoma; Middle Aged; Molecular Targeted Therapy; Neoplasm Proteins; Protein Kinase Inhibitors; Proto-Oncogene Proteins B-raf; Skin Neoplasms; Sulfonamides; Vemurafenib

Topics: Aged; Clobetasol; Diagnosis, Differential; Foot Diseases; Glucocorticoids; Humans; Male; Pagetoid Reticulosis; Psoriasis; Skin Neoplasms

Targeted BRAF inhibitor therapy (vemurafenib, dabrafenib) is an effective, novel treatment for patients with metastatic melanoma with the V600E BRAF mutation. This therapy is associated with squamous cell carcinomas and keratoacanthomas. Granulomatous eruptions have not been previously reported.. Two patients with melanoma developed cutaneous granulomatous eruptions during targeted BRAF inhibitor therapy. In case 1, after 2 months of treatment with dabrafenib and trametinib (MEK inhibitor), a papular eruption concerning for progression of disease prompted cessation of treatment. After the histopathologic diagnosis of granulomas, the patient was treated with clobetasol ointment with resolution within days and resumption of therapy. In case 2, after 5 months of vemurafenib treatment, the patient developed a granulomatous eruption, which resolved 3 weeks after cessation of therapy.. We report 2 cases of cutaneous granulomatous eruptions on treatment with targeted BRAF inhibitors, a previously unreported association. Although additional investigations are necessary to better elucidate the pathogenic mechanisms, our report includes a treatment plan that prevents unnecessary discontinuation of therapy. Given the Food and Drug Administration approval of vemurafenib for metastatic melanoma, clinicians should be aware of this possible cutaneous reaction and treatment option to optimize patient management.

Topics: Administration, Cutaneous; Aged; Aged, 80 and over; Biopsy, Needle; Clobetasol; Disease Progression; Drug Eruptions; Female; Follow-Up Studies; Humans; Imidazoles; Immunohistochemistry; Lower Extremity; Male; Melanoma; Molecular Targeted Therapy; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Oximes; Proto-Oncogene Proteins B-raf; Pyridones; Pyrimidinones; Risk Assessment; Sampling Studies; Sentinel Lymph Node Biopsy; Skin Neoplasms; Survival Rate; Treatment Outcome

A 9-year-old girl visited the department of Dermatology with an asymptomatic hypopigmented skin eruption on her upper legs, groins and trunk since 7 years. Histopathological analysis established the diagnosis of hypopigmented mycosis fungoides, a rare subtype of cutaneous T-cell lymphoma which is most commonly seen at younger age. The lesions are successfully treated with clobetasol 0.05% ointment 4 days a week.

Topics: Child; Clobetasol; Female; Glucocorticoids; Humans; Hypopigmentation; Mycosis Fungoides; Skin Neoplasms; Treatment Outcome

Cutaneous syringotropic T-cell lymphoma is a rare form of lymphoma. We report a case involving a misleading cutaneous presentation on the sole of the foot.. A 55-year-old woman presented discrete coalescent papules on her left foot, having an anhidrotic appearance, for which a number of antifungal treatments had been given without success. The skin biopsy revealed CD4+ T lymphocytic dermal infiltrate, mainly near the sweat glands, with syringotropism. The diagnosis of syringotropic T-cell lymphoma was reinforced by the presence of dominant cutaneous T-lymphocyte clone in the skin biopsy. Staging tests were negative. Treatment was initiated with an extremely potent (class IV) dermal corticosteroid.. Syringotropic T-cell lymphoma is an extremely rare form of cutaneous lymphoma similar in presentation to mycosis fungoides, characterised by the mainly perisudoral and syringotropic nature of the lymphocytic infiltrate. The value of this case report lies in the extremely mild nature of the misleading skin lesions, which could only be diagnosed through biopsy. Treatment for this condition is not as yet codified due to the extremely low number of cases reported in the literature.

Topics: Carmustine; Clobetasol; Dermatomycoses; Diagnostic Errors; Female; Foot Diseases; Humans; Middle Aged; Mycosis Fungoides; Ointments; Skin Neoplasms; Sweat Glands

Visceral involvement usually occurs in the late stages of mycosis fungoides (MF). Small bowel involvement in MF is uncommon. When involved, it could cause significant morbidity and mortality. In this study, the authors present an 89-year-old woman diagnosed with T1, N0, B1, M0; stage 1A MF, treated with topical temovate with good response who presented 3 months later with small bowel obstruction due to biopsy-proven localization of MF in the gastrointestinal tract.

Topics: Administration, Cutaneous; Aged, 80 and over; Anti-Inflammatory Agents; Clobetasol; Fatal Outcome; Female; Glucocorticoids; Humans; Intestinal Neoplasms; Intestinal Obstruction; Intestine, Small; Mycosis Fungoides; Neoplasm Staging; Skin Neoplasms

Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma. In early stages of the disease many different clinicopathologic variants have been observed. Currently, a papular variant of MF which is characterized by a good prognosis has been described.. Because only seven cases have been reported in the literature, clinical and morphological data of this variant are not well established. We report the clinical and histopathological characteristics of two new patients with papular mycosis fungoides and review the previous cases reported in the literature.. The two cases of this early variant of MF were characterized by the presence of papules which, unlike the papules of lymphomatoid papulosis, did not show a tendency for spontaneous resolution. Histologic examination confirmed the diagnosis of MF in all cases. Immunohistochemical staining for CD30 was negative in all two cases. Follow-up data of our two patients confirmed the non-aggressive behavior of the disease, confirming that the lesions were not manifestations of advanced MF.. Papular MF is a new variant of early MF characterized by a good prognosis in the long term follow- up. Thus, it should be added to the long list of clinicopathologic subtypes of MF.

Topics: Clobetasol; Female; Glucocorticoids; Humans; Immunohistochemistry; Middle Aged; Mycosis Fungoides; PUVA Therapy; Skin Neoplasms; Treatment Outcome

Topical corticosteroids such as hydrocortisone-17-butyrate (HCB) and clobetasol-17-propionate (CP) and vitamin D(3) derivatives such as calcipotriol (CAL) are widely used to treat psoriasis. The immunosuppressive effects of corticosteroids make their topical use a concern for skin carcinogenicity. Few studies have assessed the effect of topical corticosteroids and topical vitamin D(3) derivatives on photocarcinogenesis induced by ultraviolet radiation. We investigated whether HCB, CP, or CAL can accelerate photocarcinogenesis using simulated solar radiation (SSR). HCB, CP, or CAL was applied topically to the backs of hairless, female, C3.Cg/TifBomTac-immunocompetent mice in 16 groups of 25 mice each. The drugs were applied three times weekly followed by 0, 2, 4, or 6 standard erythema doses (SED) of SSR for 365 days or until death. No change was observed in the time required for tumor development in mice treated with HCB and 2 SED (HCB-2SED) and HCB-6SED. However, the time required for tumor development increased with HCB-4SED treatment. Treatment with CP-2SED did not change the time to onset of the first and second tumor, but all other CP treatments in combination with SSR increased the time. CAL-2SED decreased the time to onset of the first tumor but not of the second and third tumor. CAL-4SED and CAL-6 SED did not change or increased the time to tumor development. Our data indicated that topical administration of HCB and CAL did not alter the photocarcinogenesis of SSR and that topical CP administration had a photoprotective effect. Thus, HCB, CP, and CAL do not increase photocarcinogenesis induced by SSR.

Topics: Administration, Topical; Animals; Body Weight; Calcitriol; Carcinoma, Squamous Cell; Clobetasol; Dermatologic Agents; Female; Hydrocortisone; Kaplan-Meier Estimate; Mice; Mice, Hairless; Neoplasms, Radiation-Induced; Skin; Skin Neoplasms; Skin Pigmentation; Sunlight; Ultraviolet Rays

Topics: Clobetasol; Cyclosporine; Female; Glucocorticoids; Humans; Immunosuppressive Agents; Lymphomatoid Papulosis; Middle Aged; Pyoderma Gangrenosum; Skin Neoplasms

Topics: Administration, Topical; Aged; Clobetasol; Facial Neoplasms; Female; Glucocorticoids; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Skin Neoplasms

A 49-year-old woman presented with a seven-year history of pruritic, erythematous, scaling plaques on sun-exposed skin that localized only to pre-existing depigmented patches. Histopathologic examination showed changes consistent with cutaneous lupus erythematosus with lichenoid features and confirmed contiguous vitiligo. Diagnosis of chronic cutaneous lupus erythematosus localized to areas of vitiligo was determined by clinicopathologic correlation and may reflect an autoimmune diathesis. Consequently, hydroxychloroquine and topical glucocorticoids therapy were initiated with reported improvement in pruritus, erythema, and scale. Clinical monitoring for development of squamous-cell carcinoma in areas of chronic inflammation and sun-exposure is imperative.

Topics: Autoimmunity; Carcinoma, Squamous Cell; Clobetasol; Diabetes Complications; Diagnostic Errors; Drug Therapy, Combination; Female; Fluocinolone Acetonide; Humans; Hydroxychloroquine; Lupus Erythematosus, Discoid; Middle Aged; Photosensitivity Disorders; Pruritus; Psoriasis; Skin Neoplasms; Sunlight; Ultraviolet Rays; Vitiligo

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Clobetasol; Humans; Lymphoma, B-Cell; Lymphoma, Non-Hodgkin; Male; Mechlorethamine; Middle Aged; Skin Neoplasms

To determine the effectiveness of topical corticosteroids in the management of mycosis fungoides.. Prospective study.. Academic referral center, Veterans Affairs Medical Center, and private practice.. Seventy-nine patients with patch or plaque stage of mycosis fungoides. Fifty-one were stage T1 (less than 10% of skin involved) and 28 were stage T2 (10% or more of skin involved). Seventy-five had patch-stage and 4 had plaque-stage disease as determined by histological examination.. Patients were treated with topical class I to III corticosteroids. Of the stage T1 patients, all used class I corticosteroids, and 4 (8%) also used class II or III corticosteroids. Of the stage T2 patients, 19 (68%) used class I and 12 (43%) used class II or III compounds. Some patients used more than 1 class of corticosteroid. Applications were almost always twice daily. Three stage T1 and 2 stage T2 patients used plastic film occlusion. Baseline and monthly morning serum cortisol levels were obtained during treatment.. Response to treatment and side effects.. The median follow-up period was 9 months. Thirty-two (63%) of stage T1 patients achieved complete remission and 16 (31%) achieved partial remission, for a total response rate of 48 (94%). The comparable figures for stage T2 patients were 7 (25%), 16 (57%), and 23 (82%), respectively. Responses were determined by clinical examination. Thirty-nine patients achieved clinical clearing. In 7 of these, posttreatment biopsy specimens were obtained, and all showed histological clearing. Reversible depression of serum cortisol levels occurred in 10 (13%). Minor skin irritation occurred in 2 patients and localized, reversible skin atrophy in 1.. Topical corticosteroids, especially class I compounds, are an effective treatment for patch-stage mycosis fungoides.

Topics: Administration, Cutaneous; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Antineoplastic Agents; Betamethasone; Betamethasone Valerate; Clobetasol; Drug Administration Schedule; Female; Fluocinonide; Follow-Up Studies; Humans; Hydrocortisone; Male; Middle Aged; Mycosis Fungoides; Neoplasm Staging; Occlusive Dressings; Prospective Studies; Remission Induction; Skin Neoplasms; Treatment Outcome; Triamcinolone Acetonide

Topics: Administration, Topical; Adult; Arm; Clobetasol; Female; Humans; Leg; Nevus; Occlusive Dressings; Skin Neoplasms