Age, race, sex, stage, and incidence of cutaneous lymphoma.
ABSTRACT The incidence of the T- and B-cell CLs has been well documented, but information pertaining to racial incidence by age, and by burden of disease (stage) have not been extensively documented.
The SEER 2004-2008 public use database was investigated. The relative incidence of CL in different races and age groups was examined. Univariate and multivariate stepwise logistic regression was performed for the likelihood of presenting at a higher stage.
Of 4496 patients diagnosed with CL between 2004 and 2008; 1713 patients were diagnosed with MF, 1518 with non-MF cutaneous T-cell lymphoma, and 1265 patients with cutaneous B-cell lymphoma. For MF, there was a trend for females to be less likely to present with a higher T-stage (T3-T4) than males (odds ratio [OR], 0.73) on multivariate analysis (P = .06). For race, AA had a significantly increased risk of presenting with higher T-stage (T3-T4) MF (OR, 1.72) on multivariate analysis (P = .02), compared with white patients. For white, AA, Asian/Pacific Islander, and Native American/other/unknown, the mean age at diagnosis was 59.2, 51.5, 51.3, and 53.8. These groups presented at a significantly different age than white (P = .0001, 0.0001, and 0.0006).
Nonwhite racial groups present with MF at an earlier age compared with white, and AA have increased risk of presenting with higher T-stage compared with white. These findings have significant implications regarding need for earlier diagnosis and understanding the reasons for racial disparity in age and stage of presentation.
- [Show abstract] [Hide abstract]
ABSTRACT: Background/Objective Mycosis fungoides (MF) comprises the majority of cutaneous T-cell lymphomas (CTCLs). CTCLs associated with eosinophilia have a poor prognosis. Similar results were shown in white and black individuals with MF; however, the data on Asians is scant. In the past 10 years, few studies have provided profiles of the characteristics of MF patients in Taiwan. The purpose of this study was to investigate the demographic, clinicopathologic features, and prognosis of MF patients in Taiwan. Methods A retrospective analysis was used to evaluate patients with MF in a referral center in central Taiwan covering a period of 16 years, from 1997 to 2013. The records of 22 Taiwanese patients with MF were reviewed for clinical, laboratory, and histopathologic data and evaluated by analysis of variance. Results The male to female ratio was approximately 2:1. The average age at diagnosis was 44.8 years. One pediatric patient presented with hypopigmented MF, and the other 21 patients had typical clinical manifestations with patches-to-plaques, tumors or erythroderma. Common histopathologic features in over half of the patients included epidermotropism, atypical lymphocytes, vacuolar interface changes, and Pautrier's microabscesses. Treatment modalities, including skin-directed and systemic therapies, primarily depended on the clinical staging. Age 65 years or over (p = 0.004), and Stage IIB disease or higher (p = 0.026) were significant contributors to disease-specific mortality. There was no significant sex difference in overall survival. Of the 22 patients, 36.3% had blood eosinophilia. Blood eosinophilia was associated with Stage II disease or higher (p = 0.029) and an increased number of treatment types (p = 0.018), but not lactate dehydrogenase (LDH). Conclusion Age 65 years or over, Stage IIB disease or higher, and blood eosinophilia may be poor prognostic factors for Taiwanese patients with MF.Dermatologica Sinica 09/2014; 32(3):148–153. · 0.57 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Lymphomatoid contact dermatitis is a pseudolymphoma with clinical and histological features of allergic contact dermatitis and cutaneous T cell lymphoma. Incorrect diagnosis may lead to unnecessary testing, unnecessary treatment, or patient harm. The objective of this study is to present a case to demonstrate the diagnostic challenge and overlap between allergic contact dermatitis and cutaneous T cell lymphoma in a patient with lymphomatoid contact dermatitis caused by methylchoroisothiazolinone/methylisothiazolinone and paraben mix, and to review the existing literature in order to summarize the demographics, clinical features, allergens and treatments reported for lymphomatoid contact dermatitis. A search of major scientific databases was conducted for English-language articles reporting cases of lymphomatoid contact dermatitis or additional synonymous search headings. Nineteen articles with a total of 23 patients were analysed. Lymphomatoid contact dermatitis was more common in men, with an average age of 58.5 years. Fourteen unique allergens were identified and confirmed by patch testing. However, no single test or study was diagnostic of lymphomatoid contact dermatitis. Allergen avoidance was the most useful management tool, but selected patients required topical or systemic immunosuppression. In conclusion, without specific diagnostic features, evaluation for lymphomatoid contact dermatitis should include a thorough history and examination, patch testing, and biopsy with immunohistochemistry and clonality studies.Contact Dermatitis 10/2014; · 3.62 Impact Factor
- Journal of the American Academy of Dermatology 09/2014; 71(3):597–598. · 5.00 Impact Factor