A study of clinicopathologic profile of 15 cases of hypopigmented mycosis fungoides

Background: Mycosis fungoides (MF) is cutaneous lymphoma of the T-cell lineage. Hypopigmented MF is a clinical variant of MF, described mainly in Asians. This is a retrospective clinicopathologic analysis of hypopigmented MF at a tertiary care center. Aims: To describe the clinicopathologic profile of hypopigmented MF. Methods: Records of clinicopathologic notes over a 5-year period ranging from January 2005 up to December 2009 were reviewed over a period of 3 months, of which 15 cases were diagnosed with hypopigmented MF based on clinicopathologic correlation. Results: Hypopigmented MF was found to be more common in males, and between second and fourth decades of life. The latent period between onset and diagnosis was around 3.83 years. Most of the patients were asymptomatic 80% (12/15), with skin changes of subtle atrophy in 46.66% (7/15), scaling in 20% (3/15) and focal changes of poikiloderma in 26.66% (4/15) patients. Most common sites of distribution of the lesions were the trunk and extremities. Many of the cases had been clinically mistaken for Hansen′s disease prior to correct diagnosis. Marked epidermotropism and tagging of epidermis by large lymphocytes characterizes the condition histopathologically. Of the 15 cases, immunohistochemistry was possible in 10 cases, of which 8 showed predominant CD8 positive epidermotropic infiltrates and two cases showed absence of CD8 positive and CD4 positive lymphocytic infiltrate in the epidermis. Conclusion: Hypopigmented MF presents as hypopigmented asymptomatic patches without any erythema or infiltration in its early stage and mimics Hansen′s disease. Skin biopsy clinches the diagnosis

Effect of vitiligo on hearing – A clinical scenario

BACKGROUND: Melanocytes present in epidermis, mucous membranes, and other tissues are reduced in vitiligo, which is a chronic multifactorial illness with a complex pathophysiology. The first person to mention the existence of pigment cells in the cochlea in the inner ear was Alphonse Corti in 1831. Melanocytes are particularly prevalent in places with apparent significant secretory or metabolic function, such as Reissner's membrane, the vascular stria, and other highly vascularized areas. Only a few studies have examined the assessment of hearing in vitiligo patients, and a number of anomalies have been noted. In this regard, the goal of the current study is to use pure tone audiometry (PTA) to further demonstrate the auditory involvement in vitiligo patients. OBJECTIVE: The objective of the study is to assess the prevalence of auditory involvement in patients with vitiligo. SUBJECTS AND METHODS: It was a one-year observational study. The study included a total of 71 vitiligo patients between the age group of 18–60 years. Each patient underwent PTA, ENT examination, and dermatological evaluation. RESULTS: The mean age of the subjects in this study was 34 years, with a male predominance. When the correlation between hearing loss and vitiligo was evaluated and the left and right ears were compared, there was statistically no significant hearing loss in either ear. A mean value was calculated after taking into account the duration of vitiligo and the Vitiligo Area Scoring Index with that of hearing loss individually; however, it revealed no association between the two. CONCLUSION: Based on the study results, we can conclude that there is a need for ongoing assessment of hearing status in patients with vitiligo