RESUMO
Mycosis fungoides (MF) may present with atypical clinical manifestations. Usually it mimics various chronic dermatoses, with the appearance of ulcers during the tumour stage. Infrequently, cutaneous ulcers are the main or initial sign of lymphoma. We report the case of a man who presented multiple skin lesions that clinically appeared to be pyoderma gangrenosum (PG). However, histological and immunohistochemical examination revealed MF. This case illustrates that PG-like ulcers maybe atypical cutaneous manifestations of MF and exceptionally the presenting sign of this disease.
Assuntos
Micose Fungoide/patologia , Pioderma Gangrenoso/patologia , Úlcera Cutânea/patologia , Biópsia por Agulha , Terapia Combinada , Diagnóstico Diferencial , Evolução Fatal , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Micose Fungoide/diagnóstico , Micose Fungoide/terapia , Pioderma Gangrenoso/diagnóstico , Pioderma Gangrenoso/terapia , Índice de Gravidade de Doença , Úlcera Cutânea/diagnóstico , Úlcera Cutânea/terapiaRESUMO
Patients with lymphomas and cutaneous ulcers have a poor prognosis. Commonly the ulcers occur later in the course of lymphomas and may be the source of sepsis. From 59 patients with lymphoma and skin involvement, 12 patients who presented with ulcers were retrospectively analyzed between January 1990 to December 1999. More frequently ulcers were multiple, necrotic, infected and placed on tumors. Sepsis was the main cause of mortality in 10 patients and most cases were secondary to Staphylococcus aureus and Pseudomonas aeruginosa. Factors associated with poor prognosis were febrile neutropenia after chemotherapy and generalized involvement by the lymphoma. Mean survival of deceased patients after onset of ulcers was 6.27 months. We emphasize the importance of an appropriate microbiological study and a prompt therapy.
Assuntos
Linfoma Cutâneo de Células T/patologia , Neoplasias Cutâneas/patologia , Úlcera Varicosa/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/patologia , Linfoma Cutâneo de Células T/complicações , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Cutâneas/complicações , Úlcera Varicosa/microbiologiaRESUMO
Patients with lymphomas and cutaneous ulcers have a poor prognosis. Commonly the ulcers occur later in the course of lymphomas and may be the source of sepsis. From 59 patients with lymphoma and skin involvement, 12 patients who presented with ulcers were retrospectively analyzed between January 1990 to December 1999. More frequently ulcers were multiple, necrotic, infected and placed on tumors. Sepsis was the main cause of mortality in 10 patients and most cases were secondary to Staphylococcus aureus and Pseudomonas aeruginosa. Factors associated with poor prognosis were febrile neutropenia after chemotherapy and generalized involvement by the lymphoma. Mean survival of deceased patients after onset of ulcers was 6.27 months. We emphasize the importance of an appropriate microbiological study and a prompt therapy.