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Leukemic and Lymphomatous Infiltrates of the Skin

»	Define lymphoma.
Mycosis Fungoides
»	Is there a lymphoma that begins in the skin?
»	What type of lymphoma is mycosis fungoides?
»	How common is mycosis fungoides?
»	How does mycosis fungoides begin?
»	What is parapsoriasis?
»	What type of skin lesions are seen in patients with mycosis fungoides?
»	Describe the three subtypes of mycosis fungoides.
»	What is the TNM classification of mycosis fungoides?
»	How is mycosis fungoides treated?
»	Describe topical nitrogen mustard (HN2) therapy.
»	If a patient develops allergic contact dermatitis to topical nitrogen mustard, does the treatment have to be permanently discontinued?
»	Is photochemotherapy an effective treatment of mycosis fungoides?
»	What are the major side effects of bexarotene in the treatment of patients with cutaneous T-cell lymphoma?
»	How does one manage the side effects of bexarotene?
»	Are interferons effective in treating mycosis fungoides?
»	Is chemotherapy an effective treatment of mycosis fungoides?
»	What is extracorporeal photophoresis?
»	Are there any other FDA-approved treatments for cutaneous T-cell lymphoma?
Other Lymphomas and Leukemias
»	Outline the Ann Arbor clinical staging system for Hodgkin’s disease.
»	What is a Reed-Sternberg cell?
»	What are the histologic classes of Hodgkin’s disease?
»	Does Hodgkin’s disease occur in the skin?
»	How are cells immunophenotyped? What does the CD nomenclature mean?
»	What is lymphomatoid papulosis?
»	Are CD30-positive cells specific for lymphomatoid papulosis?
»	What is HTLV-1 virus? What is its significance?
»	Can multiple myeloma present with skin lesions only?
»	What is pseudolymphoma of the skin?
»	Can B-cell lymphomas present with skin lesions?
»	What is the most common type of leukemia in adults?
»	Can leukemia present with specific skin lesions?
»	What are some nonspecific skin lesions seen in patients with leukemia?

What is the TNM classification of mycosis fungoides?

See Table 46-1.

Hoppe R, Wood G, Able E: Mycosis fungoides and the Sézary syndrome: pathology, staging, and treatment, Curr Probl Cancer 14:295–371, 1990.

Lamberg SI: Clinical staging for cutaneous T-cell lymphoma, Ann Intern Med100:187–192, 1984.

Table 46-1. TNM Classification of Mycosis Fungoides
	STAGE		TNM CLASSIFICATION
	IA	T1	N0	M0
	IB	T2	N0	M0
	IIA	T1-T2	N1	M0
	IIB	T3	N0-N1	M0
	III	T4	N0-N1	M0
	IVA	T1-T4	N2-N3	M0
	IVB	T1-T4	N0-N3	M1