The Mycosis Fungoides Cell: The Skin Window in Mycosis Fungoides

Abstract

SUMMARY.— The skin‐window technique was applied to normal und involved skin sites of 17 patients with mycosis fungoides, 8 patients with parapsoriasis en plaque, and 6 patients with cutaneous lymphomata, and also to normal skin of 25 controls. Large mononuclear cells rapidly migrated in large numbers from plaques of mycosis fungoides and parapsoriasis. Identical cells were seen in skin windows from control sites at later intervals. No malignant cells were found in any of the skin windows of mycosis fungoides or purapsoriasis. Malignant cells were found in cases of malignant cutaneous lymphoma. Comparison of cells found on the skin windows from mycosis fungoides plaques to lymph node imprints indicates that the former are immature reticular cells without neoplastic features. We conclude that mycosis fungoides is a proliferation of these benign immature reticular cells in the skin.

Mycosis fungoides: a disease of antigen persistence

“…Similar cells have been seen with the light microscope (Flaxman, Zelazny & Van Scott, 1971) and with the electron microscope (Lutzner et al, 197I5 and Flaxman et al, 1971) in benign non-lymphomatous conditions. Vesper, Winkelmann & Hargraves (1971), using the skin window technique, considered they were benign primitive cells with no features of malignancy. Bellanti & Green (1971) considered immunological reactivity as an expression of efficiency in the elimination of foreigness.…”

Can mycosis fungoides begin in the epidermis? A hypothesis

“…Lutzner et al (1971) have seen it with the electron microscope in lichen planus and morphologically identical cells have been detected by Flaxman et al (1971) in a variety of non-lymphomatous dermatoses. Vesper, Winkelmann & Hargraves (1971), using the skin window technique, have found that the same cells migrate from normal skin as from mycosis fungoides, and on the basis of their light microscope appearance have proposed that they are benign immature reticular cells lying somewhere between a reticulum cell and a histiocyte.…”

Asymmetry of cellular response as revealed by the skin window technique

“…In the first class of investigations falls Ascheim's study of skin windows put on involved and uninvolved psoriatic skin (Ascheim et al, 1966). Another is Vesper's study of subjects with mycosis fungoides, where diseased skin is compared to the '... contralateral normal skin...' (Vesper et al, 1971). The psoriasis study revealed no mean differences in percentages of cell types at various hours; on the other hand, in the early hours of inflammation the mycosis fungoides plaques were noted to have higher median percentages of mononuclear cells than uninvolved skin.…”

“…The skin window technique is a method of recording the cellular events occurring at the skin's surface at timed intervals following an initial stimulus. It has been used to study the cell types involved in various inflammatory and neoplastic states (Ascheim et al, 1966;Eidinger, Wilkinson & Rose, 1964;Fowler & Lowell, 1966;Garrie & Wolf-Jurgensen, 1971;Hautklin, 1968;Vesper, Winkelman & Hargraves, 1971;Wolf-Jurgensen, 1962Wolf-Jurgensen, Hermingsen & Zachariae, 1969;Wolf-Jurgensen & Zachariae, 1965).…”