Mycosis fungoides of the eyelids. Two case reports

Mycosis fungoides is a distinct variant of cutaneous T cell lymphoma. We describe two male patients presenting with the third stage of the disease at the age of 56 and 67 years. The patients had large, patchy pigmented tumors all over the face and eyelids. Incisional biopsy from the lid skin revealed full-thickness involvement of the dermis by malignant lymphocytes, angiotropism, and rare figures of epidermotropism. Immunohistochemical studies showed that these malignant lymphocytes expressed CD2, CD3, CD4, CD5, and CD8 antigens but were negative for CD7 antigen. Multiagent chemotherapy and PUVA treatment were administered with limited successful outcome on their cutaneous lesions. Both patients died from problems related to the progression of the systemic disease. These two cases demonstrate the poor prognosis of the tumor stage because of strong association with widespread systemic involvement and emphasize the need for early diagnosis.