Mycosis Fungoides in Iraqi population; changing in frequency,demographic and clinical subtypes

Abstract

  Background: Mycosis fungoides (MF) is a slow-progressing primary cutaneous T-cell lymphoma. where we see the classical picture of the disease with out much attention to other clinical varients of the disease.While there is a paucity of literature on this condition in Iraqi population.  Objective:To record and evaluate the different socio-demographic factors and clinical patterns of mycosis fungoides and their varients in Iraqi patients. Patients and methods: The current study comprised a total of 108 participants with MF. All patients had a complete medical history and were evaluated clinically. Histopathology was performed on incisional biopsies. Only 20 patients were studied using immunohistochemistry.. Laboratory tests including blood cell-count, blood levels of creatinine, urea, liver enzymes, and lactate dehydrogenase (LDH).  Main outcome measures are age, gender, duration of disease, clinical subtypes,  lesions distribution and staging.   Resuls: fifty eight (53.7% patients had patch stage, 34 (31.5%)in the plaque stage, 8 (7.4%) in the tumor stage and 8 (7.4%) patients presented with erythroderma . In regards  to clinical variants : poikiloderma was seen in 44 (40.7%) patients, lichenoid variant was seen in 12 (11.11%) patients,  hypopigmented variant  in 5 (4.6%)patients  ,follicular MF in only one  patient and granulomatous in one patient.While the ordinary classical picture observed in 45 (41.66%) patients. The most common stage at diagnosis was IA (42 patients), followed by IB (32patients), IIA (18 patients), IIB ( 8 patients) and III (8 patients) . Palpable lymph nodes were detected in 18 (16.66 %) patients while visceral involvement was not detected in any patient.     Conclusion: Clinical pattern of MF at time of presentation has changed, mostly toward unusual variants of MF commonly poikelodermoid subtype.The rate of MF is higher in males than females. There seems to be  increase in frequency of this disease which go parallel with increase of other skin tumors.The reason behind this rise could be well attributed  to situation of Iraq as for decades, it  had been a stage for many wars in which almost all kinds of weapons have been used,where the depleted uranium is the most important incriminated factor.