ABSTRACT
OBJECTIVE: Transformed mycosis fungoides (T-MF) is a rare variant of MF with an aggressive course. In this study, we aimed to describe characteristics of MF/Sezary syndrome (SS) patients with transformation. MATERIALS AND METHODS: Patients diagnosed with T-MF among MF/SS patients between 2000 and 2014 in a tertiary single center were evaluated retrospectively. Demographic data, clinical data, laboratory data, immunophenotype features, response to treatment, survival, and histopathologic features were analyzed. RESULTS: Among 254 MF patients, 25 patients with T-MF were identified (10.2%) and included in the study. The male-to-female ratio was 2.6/1. The median time between MF diagnosis and transformation was 32 months (range: 0-192). Nine (36%) patients were diagnosed initially with T-MF. Advanced disease stage and high serum lactate dehydrogenase (LDH) levels were indicators of poor prognosis and treatment response. Five of the 18 patients with progressive disease had undergone allogeneic hematopoietic stem cell transplantation (allo-HSCT). Allo-HSCT resulted in complete remission in three (60%) patients. Ten (40%) patients died as a result of disease progression. Mean survival time was 25.2±14.9 (2-56) months after transformation. CONCLUSION: Advanced stage, high serum LDH levels, and loss of CD26 and CD7 expression in the peripheral blood are poor rognostic factors in T-MF. Treatment-resistant tumors and nodules should be cautionary for T-MF. Patients with T-MF have a shortened survival. Some patients may respond to first-line treatments. However, the majority of patients who do not respond to first-line therapies also are unresponsive to second or third-line therapies. Allo-HSCT may be an alternative option in patients with T-MF.
Subject(s)
Mycosis Fungoides/diagnosis , Sezary Syndrome/diagnosis , Skin Neoplasms/diagnosis , Adult , Aged , Biomarkers , Combined Modality Therapy , Female , Humans , Immunophenotyping , Kaplan-Meier Estimate , Male , Middle Aged , Mycosis Fungoides/mortality , Mycosis Fungoides/therapy , Neoplasm Staging , Prognosis , Retrospective Studies , Risk Factors , Sezary Syndrome/mortality , Sezary Syndrome/therapy , Skin/pathology , Skin Neoplasms/mortality , Skin Neoplasms/therapyABSTRACT
BACKGROUND/PURPOSE: It was aimed to investigate the ideal narrowband ultraviolet B (NB UVB) phototherapy protocol that has the maximal efficacy, minimal side effect profile, minimal cumulative UVB dose, and a shorter duration of therapy. METHODS: Fifty-one patients with psoriasis vulgaris were included in the study. The patients were divided into the percentage dose (group 1) and the fixed dose groups (group 2). In group 1, the initial NB UVB dose was 50% of the minimal erythema dose and 20% of the previous dose increase made in the next sessions, and in group 2, the starting dose and the dose increases were determined based on the skin types and applied with fixed doses. RESULTS: Psoriasis Area and Severity Index (PASI) 90 was achieved in 22 out of 27 (81.5%) patients in group 1, and in 19 out of 24 (79.2%) patients in group 2. The difference was not statistically significant (P = 0.82). No statistically significant difference was found between the two regimens in the cumulative NB UVB dose, side effect profile, and the number of sessions with improvement of the initial PASI score by 90% (for all data, P > 0.05). CONCLUSION: These two treatment protocols were not superior to each other in terms of cumulative NB UVB dose, efficacy, total number of treatment sessions, and side effect profiles.
Subject(s)
Psoriasis/radiotherapy , Ultraviolet Therapy/methods , Adolescent , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
Ingrown toenails are seen most commonly in young adults, and they can seriously affect daily life. Partial nail avulsion with chemical matrixectomy, generally by using either sodium hydroxide or phenol, is one of the most effective treatment methods. Known complications of phenol matrixectomy are unpredictable tissue damage, prolonged postoperative drainage, increased secondary infection rates, periostitis, and poor cosmetic results. To our knowledge, there have been no reports about the complications related to sodium hydroxide matrixectomy. Herein, we describe three patients who developed nail dystrophy, allodynia, and hyperalgesia after sodium hydroxide matrixectomy.
Subject(s)
Caustics/adverse effects , Hyperalgesia/chemically induced , Nails, Ingrown/therapy , Sodium Hydroxide/adverse effects , Adult , Aged , Female , Humans , Male , Nails, Ingrown/complications , Nails, Ingrown/diagnosisABSTRACT
BACKGROUND: Chemical matricectomy with sodium hydroxide is a method being used successfully in the treatment of ingrown toenail. OBJECTIVE: In this study, it was aimed to evaluate long-term recurrence rates after chemical matricectomy using sodium hydroxide application of different durations. MATERIALS AND METHODS: Two hundred two patients with ingrown nail edges were treated with either 1-minute (Group 1) or 2-minute (Group 2) applications of sodium hydroxide matricectomy. All patients were followed for at least 2 years. RESULTS: Chemical matricectomy with sodium hydroxide was applied to a total of 585 nail edges of 202 cases. The overall recurrence rates in Group 1 and Group 2 were 6.4% and 7.1%, respectively, during the average 7.5-year follow-up period. No statistically significant differences were detected in terms of recurrence between the 2 groups (p = .73). CONCLUSION: Chemical matricectomy with sodium hydroxide is an easy method in the treatment of ingrown nails, with low morbidity and high success rates. There was no difference between 1-minute and 2-minute applications in terms of recurrence during the long-term follow-up. Chemical matricectomy with 1-minute application of sodium hydroxide showed high success in terms of long-term follow-up results.
