Mycosis Fungoides-like Lesions Associated With Phenytoin Therapy

Selected Inflammatory Imitators of Mycosis Fungoides: Histologic Features and Utility of Ancillary Studies

“…41,47 Notably, patients may not display all features typical of the syndrome. 41,46,47 Drug-induced pseudolymphoma may be remarkably similar to MF with a dense, bandlike, lymphoid infiltrate in the superficial dermis; mild lymphocyte enlargement and atypia; and intraepidermal lymphocytes (Figure 4, C through H). 40,41,44 Pautrier microabscess-like structures have been reported.…”

“…[40][41][42] The clinical presentation ranges from a diffuse, maculopapular eruption to papules, plaques, and/or nodules that may be solitary or multiple. [41][42][43][44][45][46] Rare cases of erythroderma have been reported (Figure 4, A and B). 42,43,47 Medications that may cause drug-induced pseudolymphoma (DIP) are numerous and include antiepileptic drugs (eg, phenytoin, carbamazepine, sodium valproate), as well as other commonly prescribed medications, such as penicillin, b-blockers, angiotensin-converting enzyme inhibitors, and fluoxetine (as reviewed in Ploysangam et al 43 and Albrecht et al 48 ).…”

“…40,41,44 Pautrier microabscess-like structures have been reported. 41,46 However, DIP is more commonly found as a single lesion, whereas unilesional MF is uncommon. 40,44,[48][49][50] In addition, MF is more likely to involve sun-protected skin and show a variety of clinical morphologies.…”

Characterization of primary human fibroblasts transformed by human papilloma virus type 16 and herpes simplex virus type 2 DNA sequences

“…It is not known whether the chromosomal translocation in R-30 cells is a common result of phenytoin treatment. Phenytoin treatment of epileptic patients clearly leads to hyperplastic gingival growth (Hassel et al, 1983) and may be related to an increased incidence of pseudolymphoma syndrome and Hodgkin's disease (reviewed in Wolf et al, 1985). Apart from these observations, little is known concerning the deleterious side effects of prolonged use of phenytoin.…”

“…Approximately 50~ of patients taking this drug have gingival hyperplasia and overgrowth can lead to complete obstruction of teeth (Hassell et al, 1983). Pseudolymphoma syndrome and Hodgkin's disease are associated with prolonged use of phenytoin (reviewed in Wolf et al, 1985). This investigation was initiated to determine whether R-30 cells and N-16 cells differ with respect to morphological transformation.…”