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Lars Iversen - One of the best experts on this subject based on the ideXlab platform.
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risk of venous thromboembolism in patients with mycosis fungoides and Parapsoriasis a danish nationwide population based cohort study
Journal of The American Academy of Dermatology, 2017Co-Authors: Lise M. Lindahl, Morten Schmidt, Dora Kormendine Farkas, Henrik Toft Sorensen, Lars IversenAbstract:Background Mycosis fungoides (MF) and Parapsoriasis are characterized by malignant proliferation and chronic inflammation, which may affect the risk for venous thromboembolism (VTE). Objectives To examine the risk for VTE in patients with MF and Parapsoriasis. Methods We conducted a nationwide population-based cohort study in Denmark to examine the relative risk (RR) of VTE in 525 patients with MF and 634 patients with Parapsoriasis compared with that in sex- and age-matched controls from the general population. Results In patients with MF, the 10-year absolute risk for VTE was 3.4% (95% confidence interval [CI], 2.0-5.4). The adjusted RRs were 2.41 (95% CI, 1.49-3.90) for VTE and 4.01 (95% CI, 2.16-7.46) for pulmonary embolism. Notably, within the first 5 years after diagnosis with MF, the RR of pulmonary embolism was increased 6.7-fold (to 6.71 [95% CI, 2.86-15.72]). Patients with Parapsoriasis had a 2.7-fold increased RR of VTE (to 2.67 [95% CI, 1.32-5.40]) in the absence of other established VTE risk factors. Limitations We had no information regarding disease stage of MF and prescribed drugs. Conclusion Patients with MF and Parapsoriasis had an increased RR of VTE, although the absolute risk remained low. These findings should increase awareness of comorbidities in patients with MF and Parapsoriasis.
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risk of acute myocardial infarction or stroke in patients with mycosis fungoides and Parapsoriasis
Acta Dermato-venereologica, 2016Co-Authors: Lise M. Lindahl, Henrik Toft Sorensen, Uffe Heidejorgensen, Lars Pedersen, Lars IversenAbstract:Mycosis fungoides (MF) and Parapsoriasis display increased inflammation, which may be associated with increased risk of arterial cardiovascular events. The aim of this Danish nationwide population-based cohort study was to assess the relative risk (RR) of acute myocardial infarction (AMI) or stroke in patients with MF and Parapsoriasis. In patients with MF, the RR of AMI or stroke was 1.0 (95% confidence interval (95% CI) 0.7-1.3). In the second half of the study period, the RR was 1.8 (95% CI 1.1-2.9) during the first 5 years of follow-up. In men with Parapsoriasis, the RR of AMI or stroke was 1.7 (95% CI 1.1-2.7) within the first 5 years of follow-up, whereas the RR of AMI during the first 5 years of follow-up was 2.0 (95% CI 1.2-3.4). In conclusion, patients with MF and Parapsoriasis have an increased RR of AMI or stroke within the first 5 years of follow-up.
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subsequent cancers mortality and causes of death in patients with mycosis fungoides and Parapsoriasis a danish nationwide population based cohort study
Journal of The American Academy of Dermatology, 2014Co-Authors: Lise M. Lindahl, Morten Fengergron, Lars IversenAbstract:Background Data on subsequent cancers, prognostic factors for mortality, and causes of death are limited in mycosis fungoides (MF) and Parapsoriasis. Objectives To assess subsequent cancers, mortality, and causes of death in MF and Parapsoriasis. Methods Using the Danish nationwide population-based registries, we identified 368 MF patients and 582 Parapsoriasis patients and compared them with the general Danish population for subsequent cancers, mortality, and causes of death. Results Subsequent cancers were significantly increased in Parapsoriasis patients (standardized incidence ratio [SIR], 2.0 [95% confidence interval {CI}, 1.6-2.5]), and a trend was observed in MF (SIR, 1.2 [95% CI, 0.9-1.5]). Mortality was significantly increased in MF (SIR, 2.0 [95% CI, 1.8-2.3]) and Parapsoriasis (SIR, 1.3 [95% CI, 1.1-1.5]). Excess mortality from MF was highest during the first 5 years of follow-up, and causes of increased death included both malignant and nonmalignant diseases. Limitations We have no information regarding clinical stage, treatments, and patient lifestyles. Conclusion Patients with Parapsoriasis had a significantly increased risk of subsequent cancers and increased mortality. In addition, the highest excess mortality in the MF group was observed during the first 5 years of follow-up, which suggests that MF exists in both an aggressive and a more indolent form.
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Topical nitrogen mustard therapy in patients with mycosis fungoides or Parapsoriasis.
Journal of the European Academy of Dermatology and Venereology : JEADV, 2012Co-Authors: Lise M. Lindahl, Morten Fenger-grøn, Lars IversenAbstract:Background Topical nitrogen mustard is a chemotherapeutic agent used in treatment of mycosis fungoides (MF). Objective To evaluate the response and side effects in patients with MF and Parapsoriasis treated with topical nitrogen mustard. Methods A retrospective study of treatment response in 116 patients diagnosed with MF and 71 patients with Parapsoriasis and treated with topical nitrogen mustard from 1991 to 2009. Results Overall response rate and complete response (CR) rate was 91.4% and 53.4% in patients with MF and 90.1% and 40.8% in patients with Parapsoriasis, respectively. Relapse following CR was observed in 67.7% in patients with MF and 62.1% in patients with Parapsoriasis. Freedom-from-relapse was higher in patients with T1-T2 than in T3 disease (P 10% skin involvement (P = 0.05). Conclusion The present study confirms that topical nitrogen mustard is a safe and effective therapy. The treatment response in patients with Parapsoriasis was not statistically different from the response in patients with MF. This supports, that Parapsoriasis is not a distinct entity, but an early stage of MF. Nitrogen mustard should therefore still be considered as an important treatment modality in patients with early stages (Parapsoriasis) and later stages of MF either as monotherapy or in combination with other topical or systemic therapies.
Lise M. Lindahl - One of the best experts on this subject based on the ideXlab platform.
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risk of venous thromboembolism in patients with mycosis fungoides and Parapsoriasis a danish nationwide population based cohort study
Journal of The American Academy of Dermatology, 2017Co-Authors: Lise M. Lindahl, Morten Schmidt, Dora Kormendine Farkas, Henrik Toft Sorensen, Lars IversenAbstract:Background Mycosis fungoides (MF) and Parapsoriasis are characterized by malignant proliferation and chronic inflammation, which may affect the risk for venous thromboembolism (VTE). Objectives To examine the risk for VTE in patients with MF and Parapsoriasis. Methods We conducted a nationwide population-based cohort study in Denmark to examine the relative risk (RR) of VTE in 525 patients with MF and 634 patients with Parapsoriasis compared with that in sex- and age-matched controls from the general population. Results In patients with MF, the 10-year absolute risk for VTE was 3.4% (95% confidence interval [CI], 2.0-5.4). The adjusted RRs were 2.41 (95% CI, 1.49-3.90) for VTE and 4.01 (95% CI, 2.16-7.46) for pulmonary embolism. Notably, within the first 5 years after diagnosis with MF, the RR of pulmonary embolism was increased 6.7-fold (to 6.71 [95% CI, 2.86-15.72]). Patients with Parapsoriasis had a 2.7-fold increased RR of VTE (to 2.67 [95% CI, 1.32-5.40]) in the absence of other established VTE risk factors. Limitations We had no information regarding disease stage of MF and prescribed drugs. Conclusion Patients with MF and Parapsoriasis had an increased RR of VTE, although the absolute risk remained low. These findings should increase awareness of comorbidities in patients with MF and Parapsoriasis.
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risk of acute myocardial infarction or stroke in patients with mycosis fungoides and Parapsoriasis
Acta Dermato-venereologica, 2016Co-Authors: Lise M. Lindahl, Henrik Toft Sorensen, Uffe Heidejorgensen, Lars Pedersen, Lars IversenAbstract:Mycosis fungoides (MF) and Parapsoriasis display increased inflammation, which may be associated with increased risk of arterial cardiovascular events. The aim of this Danish nationwide population-based cohort study was to assess the relative risk (RR) of acute myocardial infarction (AMI) or stroke in patients with MF and Parapsoriasis. In patients with MF, the RR of AMI or stroke was 1.0 (95% confidence interval (95% CI) 0.7-1.3). In the second half of the study period, the RR was 1.8 (95% CI 1.1-2.9) during the first 5 years of follow-up. In men with Parapsoriasis, the RR of AMI or stroke was 1.7 (95% CI 1.1-2.7) within the first 5 years of follow-up, whereas the RR of AMI during the first 5 years of follow-up was 2.0 (95% CI 1.2-3.4). In conclusion, patients with MF and Parapsoriasis have an increased RR of AMI or stroke within the first 5 years of follow-up.
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subsequent cancers mortality and causes of death in patients with mycosis fungoides and Parapsoriasis a danish nationwide population based cohort study
Journal of The American Academy of Dermatology, 2014Co-Authors: Lise M. Lindahl, Morten Fengergron, Lars IversenAbstract:Background Data on subsequent cancers, prognostic factors for mortality, and causes of death are limited in mycosis fungoides (MF) and Parapsoriasis. Objectives To assess subsequent cancers, mortality, and causes of death in MF and Parapsoriasis. Methods Using the Danish nationwide population-based registries, we identified 368 MF patients and 582 Parapsoriasis patients and compared them with the general Danish population for subsequent cancers, mortality, and causes of death. Results Subsequent cancers were significantly increased in Parapsoriasis patients (standardized incidence ratio [SIR], 2.0 [95% confidence interval {CI}, 1.6-2.5]), and a trend was observed in MF (SIR, 1.2 [95% CI, 0.9-1.5]). Mortality was significantly increased in MF (SIR, 2.0 [95% CI, 1.8-2.3]) and Parapsoriasis (SIR, 1.3 [95% CI, 1.1-1.5]). Excess mortality from MF was highest during the first 5 years of follow-up, and causes of increased death included both malignant and nonmalignant diseases. Limitations We have no information regarding clinical stage, treatments, and patient lifestyles. Conclusion Patients with Parapsoriasis had a significantly increased risk of subsequent cancers and increased mortality. In addition, the highest excess mortality in the MF group was observed during the first 5 years of follow-up, which suggests that MF exists in both an aggressive and a more indolent form.
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Topical nitrogen mustard therapy in patients with mycosis fungoides or Parapsoriasis.
Journal of the European Academy of Dermatology and Venereology : JEADV, 2012Co-Authors: Lise M. Lindahl, Morten Fenger-grøn, Lars IversenAbstract:Background Topical nitrogen mustard is a chemotherapeutic agent used in treatment of mycosis fungoides (MF). Objective To evaluate the response and side effects in patients with MF and Parapsoriasis treated with topical nitrogen mustard. Methods A retrospective study of treatment response in 116 patients diagnosed with MF and 71 patients with Parapsoriasis and treated with topical nitrogen mustard from 1991 to 2009. Results Overall response rate and complete response (CR) rate was 91.4% and 53.4% in patients with MF and 90.1% and 40.8% in patients with Parapsoriasis, respectively. Relapse following CR was observed in 67.7% in patients with MF and 62.1% in patients with Parapsoriasis. Freedom-from-relapse was higher in patients with T1-T2 than in T3 disease (P 10% skin involvement (P = 0.05). Conclusion The present study confirms that topical nitrogen mustard is a safe and effective therapy. The treatment response in patients with Parapsoriasis was not statistically different from the response in patients with MF. This supports, that Parapsoriasis is not a distinct entity, but an early stage of MF. Nitrogen mustard should therefore still be considered as an important treatment modality in patients with early stages (Parapsoriasis) and later stages of MF either as monotherapy or in combination with other topical or systemic therapies.
Annamari Ranki - One of the best experts on this subject based on the ideXlab platform.
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Skin Microbiome in Small- and Large-plaque Parapsoriasis
Acta Dermato-venereologica, 2017Co-Authors: Alexander Salava, Pedro A. B. Pereira, Liisa Väkevä, Annamari Ranki, Lars Paulin, Petri Auvinen, Antti LauermaAbstract:Staphylococcal enterotoxins have been shown to promote lymphoma-associated immune dysregulation. This study examined changes in the skin microbiome of Parapsoriasis compared with intact skin. Swab microbiome specimens were taken of the Parapsoriasis lesions of 13 patients. Control samples were taken from contralateral healthy sides of the body. Microbiotas were characterized by sequencing the V1-V3 region of the 16S ribosomal RNA bacterial genes on the Illumina MiSeq platform. The most common genera in the microbiome data were Propionibacterium (27.13%), Corynebacterium (21.20%) and Staphylococcus (4.63%). Out of the Staphylococcus sequences, 39.6% represented S. epidermidis, with the rest including S. hominis, S. capitis and unidentified species. No significant differences were observed between the patients' Parapsoriasis and contralateral healthy skin or between large- and small-plaque Parapsoriasis. Notable interpersonal variation was demonstrated. These results suggest that Parapsoriasis is not associated with significant alterations in the cutaneous bacterial microbiome.
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Skin Microbiome in Small- and Large-plaque Parapsoriasis
Society for Publication of Acta Dermato-Venereologica, 2017Co-Authors: Alexander Salava, Liisa Väkevä, Annamari Ranki, Lars Paulin, Petri Auvinen, Pedro Pereira, Velma Aho, Antti LauermaAbstract:Staphylococcal enterotoxins have been shown to promote lymphoma-associated immune dysregulation. This study examined changes in the skin microbiome of Parapsoriasis compared with intact skin. Swab microbiome specimens were taken of the Parapsoriasis lesions of 13 patients. Control samples were taken from contralateral healthy sides of the body. Microbiotas were characterized by sequencing the V1–V3 region of the 16S ribosomal RNA bacterial genes on the Illumina MiSeq platform. The most common genera in the microbiome data were Propionibacterium (27.13%), Corynebacterium (21.20%) and Staphylococcus (4.63%). Out of the Staphylococcus sequences, 39.6% represented S. epidermidis, with the rest including S. hominis, S. capitis and unidentified species. No significant differences were observed between the patients’ Parapsoriasis and contralateral healthy skin or between large- and small-plaque Parapsoriasis. Notable interpersonal variation was demonstrated. These results suggest that Parapsoriasis is not associated with significant alterations in the cutaneous bacterial microbiome
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a retrospective study of the probability of the evolution of Parapsoriasis en plaques into mycosis fungoides
Acta Dermato-venereologica, 2005Co-Authors: Liisa Väkevä, Seppo Sarna, Annikki Vaalasti, Eero Pukkala, Arjaleena Kariniemi, Annamari RankiAbstract:Parapsoriasis en plaque has been suggested to be an early manifestation of mycosis fungoides (cutaneous T-cell lymphoma). We explored the disease course of patients with small plaque or large plaque Parapsoriasis in a 26-year retrospective cohort analysis of 105 Parapsoriasis patients, who were clinically and histopathologically followed up in Helsinki and Tampere University Hospitals. Eventual later cancers of these patients were verified from the Finnish Cancer Registry. In the small plaque Parapsoriasis group, 7 patients (10%) and in the large plaque Parapsoriasis group 12 patients (35%), developed histologically confirmed mycosis fungoides during a median of 10 and 6 years, respectively. No significant differences were found regarding the risk of developing mycosis fungoides or the tendency to remission in patients treated with or without phototherapy. Our results show that not only large plaque Parapsoriasis, but also small plaque Parapsoriasis, as currently defined in textbooks, can progress to mycosis fungoides. The benefits of phototherapy are equivocal in Parapsoriasis treatment as far as progression to cancer is concerned.
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chromosomal abnormalities in cutaneous t cell lymphoma and in its premalignant conditions as detected by g banding and interphase cytogenetic methods
Journal of Investigative Dermatology, 1997Co-Authors: Leena Karenko, Annamari Ranki, Eija Hyytinen, Seppo SarnaAbstract:The etiology of cutaneous T-cell lymphomas (CTCL) is unknown. We studied the pattern of chromosomal abnormalities with G-banding and interphase in situ hybridization methods in blood mononuclear cells in 17 patients representing the different phases of CTCL or the premalignant condition, Parapsoriasis en plaque and in 10 control persons. We used biotinylated centromere-specific probes with fluorescent detection (FISH) for chromosomes 1, 11, 8 and 17 and similar, enzymatically detectable, digoxigenin-labeled probes for chromosomes 1, 6, 12, 17 and 18. In G-banding, all patients showed numerical and structural chromosome aberrations. Numerical aberrations of chromosomes 6, 13, 15 and 17, marker chromosomes and structural aberrations of chromosomes 3, 9 and 13 were increased in mycosis fungoides (MF) compared with healthy controls. In four of five patients the detection of a chromosomal clone preceded relapse or progression of the disease. In FISH of interphase cells, the cells abnormal for chromosomes 8 or 11 and for all four chromosomes collectively, were increased in MF and in Sezary Syndrome (SS). FISH and G-banding methods agreed statistically significantly for the detection of monosomy. Also, digoxigenin-labeled probes hybridized to interphases or mitoses detected aberrations corresponding to those observed with G-banding. Thus, chromosomally abnormal cells can be found in the peripheral blood of both Parapsoriasis en plaque and CTCL patients. They can be detected with interphase cytogenetical methods, which obviates the need for dividing cells, often difficult to accomplish in CTCL.
Brigitte Dreno - One of the best experts on this subject based on the ideXlab platform.
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evaluation of the role of human herpes virus 6 and 8 in Parapsoriasis
Experimental Dermatology, 2009Co-Authors: G Quereux, Elisabeth Andregarnier, Annechantal Knol, Berthemarie Imbertmarcille, Brigitte DrenoAbstract:Introduction: The aetiology of mycosis fungoides and Parapsoriasis (which may be considered as an early stage of mycosis fungoides) remains debated. Previous recent studies have suspected the involvement of viral agents and particularly human herpes viruses (HHV).The aim of the present study was to screen for the presence of HHV-6 and HHV-8 genome in Parapsoriasis samples. Method: Fifty paraffin-embedded samples from skin biopsies of Parapsoriasis were retrospectively collected from archival files in our Dermatology department. Total DNA was extracted from samples using the phenol–chloroform method and the presence of viral genomes was screened using real-time PCR. Results: Forty nine out of the fifty tissue samples of Parapsoriasis were interpretable, they were all found negative for HHV-6 and HHV-8. Discussion: This study does not confirm the suspected role of HHV-6 or -8 in Parapsoriasis. HHV-8 has been the most studied virus in Parapsoriasis and more widely in cutaneous lymphoproliferative diseases and our results are in agreement with most of the studies which found none or few HHV-8 in more advanced stages of cutaneous lymphoproliferative diseases. Concerning HHV-6, our study is the first one investigating the presence of this virus in lesional tissue samples of patients with Parapsoriasis. In conclusion, Parapsoriasis does not seem to be associated with either HHV-6 or HHV-8.
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toll like receptors 2 4 and 9 expression in cutaneous t cell lymphoma mycosis fungoides and sezary syndrome
European Journal of Dermatology, 2006Co-Authors: V Jarrousse, G Quereux, Annechantal Knol, S Marquesbriand, Amir Khammari, Brigitte DrenoAbstract:The aim of this work was to study Toll-like receptors (TLRs) 2, 4 and 9 expression patterns in Parapsoriasis and in cutaneous T-cell lymphoma (CTCL): Mycosis fungoides (MF) and Sezary syndrome (SS) at different stages of the illness. The expression of TLRs was examined by immunohistochemistry on paraffin-embedded biopsies. Normal skin, atopic dermatitis and psoriasis, were used as controls. In cutaneous lesions of inflammatory diseases (atopic dermatitis, psoriasis) the expression of TLR2, TLR4 and TLR9 was low compared to normal skin. In Parapsoriasis the expression of the three TLRs was similar to control. By contrast, in MF skin we observed a strong intensity of labelling with the three TLRs in the epidermis. Concerning SS, the expression of TLR2, TLR4 and TLR9 was intermediate between inflammatory lesions and MF. Thus, the development of skin lesions in MF appears associated with an increase of TLR2, TLR4 and TLR9 expression by keratinocytes in cutaneous lesions, which could play a role in the chronic activation of T lymphocytes in the skin.
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interleukin 15 expression in cutaneous t cell lymphoma mycosis fungoides and sezary syndrome
British Journal of Dermatology, 2001Co-Authors: Sabine Leroy, Sigrid Dubois, Isabelle Tenaud, Nathalie Chebassier, Anne Godard, Yannick Jacques, Brigitte DrenoAbstract:Background Cytokines are of potential importance in the pathogenesis of cutaneous T-cell mediated disorders, including cutaneous T-cell lymphoma (CTCL). Objectives To compare interleukin (IL)-15 expression in certain inflammatory cutaneous diseases, with that in CTCL (mycosis fungoides and Sezary syndrome). Methods IL-15 mRNA and protein expression were examined by in situ hybridization and immunohistochemistry, respectively, on formalin-fixed, paraffin-embedded biopsies of normal human skin, atopic dermatitis, psoriasis, Parapsoriasis and CTCL. Results Despite similar expression of IL-15 mRNA, we found differences in IL-15 protein expression between normal human skin, atopic dermatitis and psoriasis on the one hand, and Parapsoriasis and CTCL on the other. IL-15 protein expression was not detected in normal human skin, atopic dermatitis or psoriasis, but was detected, mainly at low levels but in a few patients at higher levels, in epidermal keratinocytes in Parapsoriasis, mycosis fungoides and Sezary syndrome. Conclusions Induction of keratinocyte IL-15 expression appears to be a feature of CTCL. The factors stimulating such an expression remain unknown.
Henrik Toft Sorensen - One of the best experts on this subject based on the ideXlab platform.
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risk of venous thromboembolism in patients with mycosis fungoides and Parapsoriasis a danish nationwide population based cohort study
Journal of The American Academy of Dermatology, 2017Co-Authors: Lise M. Lindahl, Morten Schmidt, Dora Kormendine Farkas, Henrik Toft Sorensen, Lars IversenAbstract:Background Mycosis fungoides (MF) and Parapsoriasis are characterized by malignant proliferation and chronic inflammation, which may affect the risk for venous thromboembolism (VTE). Objectives To examine the risk for VTE in patients with MF and Parapsoriasis. Methods We conducted a nationwide population-based cohort study in Denmark to examine the relative risk (RR) of VTE in 525 patients with MF and 634 patients with Parapsoriasis compared with that in sex- and age-matched controls from the general population. Results In patients with MF, the 10-year absolute risk for VTE was 3.4% (95% confidence interval [CI], 2.0-5.4). The adjusted RRs were 2.41 (95% CI, 1.49-3.90) for VTE and 4.01 (95% CI, 2.16-7.46) for pulmonary embolism. Notably, within the first 5 years after diagnosis with MF, the RR of pulmonary embolism was increased 6.7-fold (to 6.71 [95% CI, 2.86-15.72]). Patients with Parapsoriasis had a 2.7-fold increased RR of VTE (to 2.67 [95% CI, 1.32-5.40]) in the absence of other established VTE risk factors. Limitations We had no information regarding disease stage of MF and prescribed drugs. Conclusion Patients with MF and Parapsoriasis had an increased RR of VTE, although the absolute risk remained low. These findings should increase awareness of comorbidities in patients with MF and Parapsoriasis.
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risk of acute myocardial infarction or stroke in patients with mycosis fungoides and Parapsoriasis
Acta Dermato-venereologica, 2016Co-Authors: Lise M. Lindahl, Henrik Toft Sorensen, Uffe Heidejorgensen, Lars Pedersen, Lars IversenAbstract:Mycosis fungoides (MF) and Parapsoriasis display increased inflammation, which may be associated with increased risk of arterial cardiovascular events. The aim of this Danish nationwide population-based cohort study was to assess the relative risk (RR) of acute myocardial infarction (AMI) or stroke in patients with MF and Parapsoriasis. In patients with MF, the RR of AMI or stroke was 1.0 (95% confidence interval (95% CI) 0.7-1.3). In the second half of the study period, the RR was 1.8 (95% CI 1.1-2.9) during the first 5 years of follow-up. In men with Parapsoriasis, the RR of AMI or stroke was 1.7 (95% CI 1.1-2.7) within the first 5 years of follow-up, whereas the RR of AMI during the first 5 years of follow-up was 2.0 (95% CI 1.2-3.4). In conclusion, patients with MF and Parapsoriasis have an increased RR of AMI or stroke within the first 5 years of follow-up.
