Syringotropic mycosis fungoides: clinical and histologic features, response to treatment, and outcome in 19 patients

J Am Acad Dermatol. 2014 Nov;71(5):926-34. doi: 10.1016/j.jaad.2014.06.033. Epub 2014 Jul 18.

Abstract

Background: A rare variant of mycosis fungoides (MF), syringotropic MF (STMF) is characterized by a particular tropism of the lymphocytic infiltrate for the eccrine structures, and included in the follicular subtype of MF in the World Health Organization-European Organization for Research and Treatment of Cancer classification of cutaneous lymphomas.

Objective: We sought to determine the clinicopathologic features and disease course of patients with STMF.

Methods: A retrospective study was conducted to identify patients with STMF from 1998 to 2013.

Results: Nineteen patients were included: 15 men and 4 women, mean age 55 years (range, 24-86). Most had multiple lesions (n=16, 84%) with associated alopecia (n=12, 63%) and/or punctuated aspect (n=12, 63%). Palms or soles were involved in 10 cases (53%). Folliculotropism was found in 13 cases (68%). After a median follow-up of 70 months (range, 2-140), 3 patients died, 1 from disease-related death. The 5-year overall and disease-specific survival were 100%. The disease-specific survival was significantly higher than in 54 patients with folliculotropic MF without syringotropism (5-year disease-specific survival, 74%; 95% confidence interval, 58%-94%, P=.02).

Limitations: Retrospective setting is a limitation.

Conclusions: In the spectrum of adnexotropic MF, STMF appears as a distinct entity from follicular MF, with peculiar clinical characteristics and natural history.

Keywords: cutaneous T-cell lymphoma; follicular; folliculotropism; mycosis fungoides; syringotropic; syringotropism.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alopecia / etiology*
  • Eccrine Glands
  • Female
  • Hair Follicle
  • Humans
  • Lymphocytes / physiology
  • Male
  • Middle Aged
  • Mycosis Fungoides / complications
  • Mycosis Fungoides / drug therapy
  • Mycosis Fungoides / pathology*
  • Retrospective Studies
  • Skin Neoplasms / complications
  • Skin Neoplasms / drug therapy
  • Skin Neoplasms / pathology*
  • Survival Rate
  • Treatment Outcome
  • Tropism
  • Young Adult