Nail involvement in mycosis fungoides: brief report

Mycosis fungoides (MF) is the commonest T-Cell lymphoma (CTCL) involving skin and its appendages to variable degrees. Nail involvement is one of multiple dermatologic manifestation of this disorder and could have negative impact on psychological status of patients and producing therapeutic challenge to physician. We aimed to evaluate prevalence and subtypes of nail involvement in MF patients attending dermatology clinic, Razi Hospital in Tehran, Iran. All patients having MF confirmed via histopathology, visiting Razi Hospital Dermatology Clinic, Phototherapy and follow-up on inpatient wards from 2010 to 2011, were included. Patients examined by dermatologist researcher focusing on nail changes and all detected nail changes including onycholysis, longitudinal ridges and 11 more other changes, recorded in appropriated questionnaires. Treatment regimen prescribed to the patients also recorded as well as clinical CTCL staging. A total of 60 patients, including 28 (46.7%) males and 32 (53.3%) females entered the study. 18 patients (12 males and 6 females) had different nail changes including longitudinal ridging, leukonychia, pitting and nine more morphological changes in decrescendo order. Ten patients had smoking history including four patients with nail changes. The commonest used treatment was local bath Psoralen and UVA light therapy (PUVA). Overall nail involvement in our study was approximately 30%. There was no significant relationship between prevalence of nail changes, demographic and clinical specification of underlying CTCL disorder especially tumor stage. Also, no significant relationship between prevalence and type of nail involvement with prescribed therapeutic regimen was found. We found about 30% prevalence that is a little higher than previously shown. It seems that nail changes in CTCL have no relationship to CTCL staging or other specifications including demographic specifications.