While mycosis fungoides (MF) is typically an indolent malignancy, it may infrequently undertake an aggressive course. We used proteomic analyses to identify a biomarker of the aggressive course of MF. Results of this investigation demonstrated that PARP-1, heat-shock protein family A (Hsp70) member 1 like (HSAP1L), Hsp70 member 1A (HSPA1A), ATP-depending RNA helicase (DDX17) and the α-isoform of lamina-associated polypeptide 2 (TMPO) had higher expression in aggressive disease versus non-aggressive. Moreover, PARP-1 was overexpressed in patients with early stage of MF who developed later an aggressive disease. PARP-1 was evaluated as a new target for therapy, demonstrating the selective dose-dependent cytotoxic effect of PARP inhibitors on Sézary cells in comparison with non-malignant lymphocytes. In conclusion, we believe that PARP-1 may serve not only as a biomarker at initial biopsies for a disease that may become aggressive but also as a new therapeutic target of advanced MF and Sézary syndrome.

Background: Cryolipolysis is a noninvasive treatment for the reduction of localized adipose tissue. It is becoming an increasingly popular procedure since it received Food and Drug Administration approval in 2010. Localized collections of excess adipose tissue are cooled which results in selective apoptosis of adipocytes. Aims: Review of effectiveness and side effects of cryolipolysis treatments. Materials and Methods: Literature Review. Results: Studies have demonstrated the effectiveness of cryolipolysis for the treatment of several body regions. Cryolipolysis is contraindicated for patients with cold-induced conditions and other cutaneous disorders. Most side effects are minor including erythema and local discomfort which typically resolve within a few weeks of the procedure. A rare complication of treatment is paradoxical adipose hyperplasia. Discussion: There are several other effective noninvasive modalities for reducing localized adipose tissue. Combining these treatments with cryolipolysis has been shown to be more effective. As technology improves, newer devices have been developed with improved applicators and beneficial results. Conclusion: Cosmetic procedures continue to increase in popularity and physicians should be familiar with cryolipolysis for the reduction of localized adipose tissue collections.

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Romidepsin belongs to a class of medications called histone deacetylase inhibitors and is currently approved for treatment of cutaneous and peripheral T-cell lymphomas. Romidepsin was previously investigated for the treatment of chronic lymphocytic leukemia (CLL), and demonstrated potential benefit, but interest in its use declined following phase I clinical trials that showed poor tolerance of a significant side effect profile. We presented a patient with a history of stage II CLL, referred to dermatology for treatment of new-onset of mycosis fungoides (MF), who was treated with romidepsin over seven months. The patient achieved a partial response with 50% decrease in body surface area occupied by MF, thinning of remaining plaques, and near complete response in his CLL. His absolute lymphocyte count remained within the normal range for four months following discontinuation of romidepsin. Side effects were well-tolerated and did not limit therapy. Current literature on romidepsin is reviewed and compared to existing treatments for CLL.

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