[Skip to Content]
[Skip to Content Landing]

Mycosis Fungoides in Children and AdolescentsA Systematic Review

Educational Objective
To describe the clinical features, immunophenotypes, various treatment options, and prognosis of mycosis fungoides in children and adolescents.
1 Credit CME
Key Points

Question  What are the clinical features of childhood mycosis fungoides (MF)?

Findings  In this systematic review of 571 children and adolescents with MF, the most common subtype was the hypopigmented form, followed by classic MF. Most patients with MF presented with early-stage disease, and the prognosis of MF seems to be more favorable than in the general population, although a significant delay before the establishment of a correct diagnosis of MF in childhood was associated with a poor prognosis.

Meaning  These findings suggest that although the prognosis of childhood MF is not unfavorable, delayed diagnosis may have an adverse effect.

Abstract

Importance  Comprehensive data on childhood mycosis fungoides (MF) is scarce.

Objective  To describe clinical features, immunophenotypes, various treatment options, and prognosis of MF in children and adolescents.

Evidence Review  This systematic review searched MEDLINE via PubMed, Embase, Cochrane, and Scopus databases in October 2019. The search terms included mycosis fungoides, infant, children, and adolescent. No filter for the publication period was used, but studies written in a language other than English were excluded. Reference lists of the relevant articles were also searched manually. Case series and case reports were included if data on childhood MF were extractable. The Asan Medical Center database for cases of childhood MF was also searched. Patients were treated from January 1, 1990, to July 31, 2019, and were younger than 20 years at the time of diagnosis. The methodologic quality of the included studies was assessed with items from the Newcastle-Ottawa scale. Data were analyzed from December 9, 2019, to September 4, 2020.

Findings  A total of 571 unique patients were included. The mean (SD) age at diagnosis was 12.2 (4.2) years; at onset, 8.6 (4.2) years. The female-to-male ratio was 1:1.6 (350 male patients [61.3%]). Among 522 patients with data available at diagnosis, stage 1 disease constituted 478 cases (91.6%), followed by stage 2 (39 [7.5%]) and stage 4 (5 [1.0%]). Among the 567 patients with data available, the most common variant of MF was the hypopigmented form (309 [54.5%]), followed by classic MF (187 [33.0%]). The MF lesions were predominantly the CD4+ and CD8+ immunophenotype in 99 (49.5%) and 79 (39.5%) of 200 patients, respectively. Among the treatments, narrowband UV-B was the most frequently used (150 of 426 [35.2%]). Most patients were alive with the disease (185 of 279 [66.3%]); 83 of 279 (29.8%) were in complete remission; and 11 of 279 (3.9%) had died by the last follow-up. A longer time from onset to diagnosis (hazard ratio [HR], 1.24; 95% CI, 1.06-1.45), granulomatous slack skin (HR, 12.25; 95% CI, 1.99-75.26), granulomatous MF (HR, 14.59; 95% CI, 1.31-162.00), a history of organ transplant (HR, 10.15; 95% CI, 0.98-105.37), and stage 2 disease at the time of diagnosis (HR, 10.22; 95% CI, 2.94-35.50) were associated with worse outcomes.

Conclusions and Relevance  The findings of this review suggest that there is often a significant delay until the establishment of a correct diagnosis of childhood MF, which may be detrimental to the prognosis.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 Credit(s)™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: January 14, 2021.

Published Online: March 3, 2021. doi:10.1001/jamadermatol.2021.0083

Corresponding Author: Woo Jin Lee, MD, PhD, Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea (uucm79@hanmail.net).

Author Contributions: Drs Jung and W. J. Lee had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Jung, Chang, M. W. Lee, W. J. Lee.

Acquisition, analysis, or interpretation of data: Jung, Lim, Won, W. J. Lee.

Drafting of the manuscript: Jung, Lim, W. J. Lee.

Critical revision of the manuscript for important intellectual content: Jung, Won, Chang, M. W. Lee, W. J. Lee.

Statistical analysis: Jung, Lim, W. J. Lee.

Administrative, technical, or material support: Won, W. J. Lee.

Supervision: Won, Chang, M. W. Lee, W. J. Lee.

Conflict of Interest Disclosures: None reported.

References
1.
Criscione  VD , Weinstock  MA .  Incidence of cutaneous T-cell lymphoma in the United States, 1973-2002.   Arch Dermatol. 2007;143(7):854-859. doi:10.1001/archderm.143.7.854 PubMedGoogle ScholarCrossref
2.
Peters  MS , Thibodeau  SN , White  JW  Jr , Winkelmann  RK .  Mycosis fungoides in children and adolescents.   J Am Acad Dermatol. 1990;22(6 pt 1):1011-1018. doi:10.1016/0190-9622(90)70143-6 PubMedGoogle ScholarCrossref
3.
Burns  MK , Ellis  CN , Cooper  KD .  Mycosis fungoides–type cutaneous T-cell lymphoma arising before 30 years of age: immunophenotypic, immunogenotypic and clinicopathologic analysis of nine cases.   J Am Acad Dermatol. 1992;27(6, pt 1):974-978. doi:10.1016/0190-9622(92)70297-S PubMedGoogle ScholarCrossref
4.
Crowley  JJ , Nikko  A , Varghese  A , Hoppe  RT , Kim  YH .  Mycosis fungoides in young patients: clinical characteristics and outcome.   J Am Acad Dermatol. 1998;38(5, pt 1):696-701. doi:10.1016/S0190-9622(98)70198-7 PubMedGoogle ScholarCrossref
5.
Quaglino  P , Zaccagna  A , Verrone  A , Dardano  F , Bernengo  MG .  Mycosis fungoides in patients under 20 years of age: report of 7 cases, review of the literature and study of the clinical course.   Dermatology. 1999;199(1):8-14. doi:10.1159/000018196 PubMedGoogle ScholarCrossref
6.
Wain  EM , Orchard  GE , Whittaker  SJ , Spittle  MF , Russell-Jones  R .  Outcome in 34 patients with juvenile-onset mycosis fungoides: a clinical, immunophenotypic, and molecular study.   Cancer. 2003;98(10):2282-2290. doi:10.1002/cncr.11780 PubMedGoogle ScholarCrossref
7.
Fink-Puches  R , Chott  A , Ardigó  M ,  et al.  The spectrum of cutaneous lymphomas in patients less than 20 years of age.   Pediatr Dermatol. 2004;21(5):525-533. doi:10.1111/j.0736-8046.2004.21500.x PubMedGoogle ScholarCrossref
8.
Nanda  A , Al-Ajmi  H .  Mycosis fungoides in children and adolescents.   Expert Rev Dermatol. 2013;8(3):309-320. doi:10.1586/edm.13.29 Google ScholarCrossref
9.
Ben-Amitai  D , Michael  D , Feinmesser  M , Hodak  E .  Juvenile mycosis fungoides diagnosed before 18 years of age.   Acta Derm Venereol. 2003;83(6):451-456. doi:10.1080/00015550310020530 PubMedGoogle ScholarCrossref
10.
Furlan  FC , Sanches  JA .  Hypopigmented mycosis fungoides: a review of its clinical features and pathophysiology.   An Bras Dermatol. 2013;88(6):954-960. doi:10.1590/abd1806-4841.20132336Google Scholar
11.
Hickham  PR , McBurney  EI , Fitzgerald  RL .  CTCL in patients under 20 years of age: a series of five cases.   Pediatr Dermatol. 1997;14(2):93-97. doi:10.1111/j.1525-1470.1997.tb00212.x PubMedGoogle ScholarCrossref
12.
Yazganoglu  KD , Topkarci  Z , Buyukbabani  N , Baykal  C .  Childhood mycosis fungoides: a report of 20 cases from Turkey.   J Eur Acad Dermatol Venereol. 2013;27(3):295-300. doi:10.1111/j.1468-3083.2011.04383.x PubMedGoogle ScholarCrossref
13.
Heng  YK , Koh  MJ , Giam  YC , Tang  MB , Chong  WS , Tan  SH .  Pediatric mycosis fungoides in Singapore: a series of 46 children.   Pediatr Dermatol. 2014;31(4):477-482. doi:10.1111/pde.12352 PubMedGoogle ScholarCrossref
14.
Wu  JH , Cohen  BA , Sweren  RJ .  Mycosis fungoides in pediatric patients: clinical features, diagnostic challenges, and advances in therapeutic management.   Pediatr Dermatol. 2020;37(1):18-28. doi:10.1111/pde.14026 PubMedGoogle ScholarCrossref
15.
Willemze  R , Jaffe  ES , Burg  G ,  et al.  WHO-EORTC classification for cutaneous lymphomas.   Blood. 2005;105(10):3768-3785. doi:10.1182/blood-2004-09-3502 PubMedGoogle ScholarCrossref
16.
Pimpinelli  N , Olsen  EA , Santucci  M ,  et al; International Society for Cutaneous Lymphoma.  Defining early mycosis fungoides.   J Am Acad Dermatol. 2005;53(6):1053-1063. doi:10.1016/j.jaad.2005.08.057 PubMedGoogle ScholarCrossref
17.
Moher  D , Liberati  A , Tetzlaff  J , Altman  DG ; PRISMA Group.  Preferred Reporting Items for Systematic Reviews and Meta-analyses: the PRISMA statement.   PLoS Med. 2009;6(7):e1000097. doi:10.1371/journal.pmed.1000097PubMedGoogle Scholar
18.
Jung  JM , Lim  D , Lee  WJ , et al. Mycosis fungoides in children and adolescents: a systematic review. National Institute for Health Research; PROSPERO CRD42020156847. Published April 28, 2020. Accessed November 1, 2019. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=156847
19.
Murad  MH , Sultan  S , Haffar  S , Bazerbachi  F .  Methodological quality and synthesis of case series and case reports.   BMJ Evid Based Med. 2018;23(2):60-63. doi:10.1136/bmjebm-2017-110853 PubMedGoogle ScholarCrossref
20.
Kim  YH , Liu  HL , Mraz-Gernhard  S , Varghese  A , Hoppe  RT .  Long-term outcome of 525 patients with mycosis fungoides and Sézary syndrome: clinical prognostic factors and risk for disease progression.   Arch Dermatol. 2003;139(7):857-866. doi:10.1001/archderm.139.7.857 PubMedGoogle ScholarCrossref
21.
Agar  NS , Wedgeworth  E , Crichton  S ,  et al.  Survival outcomes and prognostic factors in mycosis fungoides/Sézary syndrome: validation of the revised International Society for Cutaneous Lymphomas/European Organisation for Research and Treatment of Cancer staging proposal.   J Clin Oncol. 2010;28(31):4730-4739. doi:10.1200/JCO.2009.27.7665 PubMedGoogle ScholarCrossref
22.
Scarisbrick  JJ , Prince  HM , Vermeer  MH ,  et al.  Cutaneous lymphoma international consortium study of outcome in advanced stages of mycosis fungoides and Sezary syndrome: effect of specific prognostic markers on survival and development of a prognostic model.   J Clin Oncol. 2015;33(32):3766-3773. doi:10.1200/JCO.2015.61.7142 PubMedGoogle ScholarCrossref
23.
Talpur  R , Singh  L , Daulat  S ,  et al.  Long-term outcomes of 1,263 patients with mycosis fungoides and Sézary syndrome from 1982 to 2009.   Clin Cancer Res. 2012;18(18):5051-5060. doi:10.1158/1078-0432.CCR-12-0604 PubMedGoogle ScholarCrossref
24.
Nikolaou  V , Papadavid  E , Patsatsi  A ,  et al.  Prognostic indicators for mycosis fungoides in a Greek population.   Br J Dermatol. 2017;176(5):1321-1330. doi:10.1111/bjd.15000 PubMedGoogle ScholarCrossref
25.
Desai  M , Liu  S , Parker  S .  Clinical characteristics, prognostic factors, and survival of 393 patients with mycosis fungoides and Sézary syndrome in the southeastern United States: a single-institution cohort.   J Am Acad Dermatol. 2015;72(2):276-285. doi:10.1016/j.jaad.2014.10.019 PubMedGoogle ScholarCrossref
26.
Kashani-Sabet  M , McMillan  A , Zackheim  HS .  A modified staging classification for cutaneous T-cell lymphoma.   J Am Acad Dermatol. 2001;45(5):700-706. doi:10.1067/mjd.2001.117722 PubMedGoogle ScholarCrossref
27.
Novelli  S , García-Muret  P , Mozos  A , Sierra  J , Briones  J .  Total body-surface area as a new prognostic variable in mycosis fungoides and Sézary syndrome.   Leuk Lymphoma. 2016;57(5):1060-1066. doi:10.3109/10428194.2015.1057894 PubMedGoogle ScholarCrossref
28.
Abeni  D , Frontani  M , Sampogna  F ,  et al.  Circulating CD8+ lymphocytes, white blood cells, and survival in patients with mycosis fungoides.   Br J Dermatol. 2005;153(2):324-330. doi:10.1111/j.1365-2133.2005.06755.x PubMedGoogle ScholarCrossref
29.
Luo  YX , Liu  ZR , Liu  J , Liu  YH , Zhang  W , Zhang  Y .  Mycosis fungoides and variants of mycosis fungoides: a retrospective study of 93 patients in a Chinese population at a single center.   Ann Dermatol. 2020;32(1):14-20. doi:10.5021/ad.2020.32.1.14 Google ScholarCrossref
30.
Alsaleh  QA , Nanda  A , Al-Ajmi  H ,  et al.  Clinicoepidemiological features of mycosis fungoides in Kuwait, 1991-2006.   Int J Dermatol. 2010;49(12):1393-1398. doi:10.1111/j.1365-4632.2010.04567.x PubMedGoogle ScholarCrossref
31.
Abbott  RA , Sahni  D , Robson  A , Agar  N , Whittaker  S , Scarisbrick  JJ .  Poikilodermatous mycosis fungoides: a study of its clinicopathological, immunophenotypic, and prognostic features.   J Am Acad Dermatol. 2011;65(2):313-319. doi:10.1016/j.jaad.2010.05.041 PubMedGoogle ScholarCrossref
32.
Nikolaou  VA , Papadavid  E , Katsambas  A ,  et al.  Clinical characteristics and course of CD8+ cytotoxic variant of mycosis fungoides: a case series of seven patients.   Br J Dermatol. 2009;161(4):826-830. doi:10.1111/j.1365-2133.2009.09301.x PubMedGoogle ScholarCrossref
33.
Diwan  H , Ivan  D .  CD8-positive mycosis fungoides and primary cutaneous aggressive epidermotropic CD8-positive cytotoxic T-cell lymphoma.   J Cutan Pathol. 2009;36(3):390-392. doi:10.1111/j.1600-0560.2008.01259.x PubMedGoogle ScholarCrossref
34.
El-Shabrawi-Caelen  L , Cerroni  L , Medeiros  LJ , McCalmont  TH .  Hypopigmented mycosis fungoides: frequent expression of a CD8+ T-cell phenotype.   Am J Surg Pathol. 2002;26(4):450-457. doi:10.1097/00000478-200204000-00006 PubMedGoogle ScholarCrossref
35.
Martinez-Escala  ME , Kantor  RW , Cices  A ,  et al.  CD8+ mycosis fungoides: a low-grade lymphoproliferative disorder.   J Am Acad Dermatol. 2017;77(3):489-496. doi:10.1016/j.jaad.2017.05.015 PubMedGoogle ScholarCrossref
36.
Bergman  R , Faclieru  D , Sahar  D ,  et al.  Immunophenotyping and T-cell receptor gamma gene rearrangement analysis as an adjunct to the histopathologic diagnosis of mycosis fungoides.   J Am Acad Dermatol. 1998;39(4, pt 1):554-559. doi:10.1016/S0190-9622(98)70003-9 PubMedGoogle ScholarCrossref
37.
Harms  KL , Harms  PW , Anderson  T ,  et al.  Mycosis fungoides with CD20 expression: report of two cases and review of the literature.   J Cutan Pathol. 2014;41(6):494-503. doi:10.1111/cup.12299 PubMedGoogle ScholarCrossref
38.
Wain  EM , Orchard  GE , Mayou  S , Atherton  DJ , Misch  KJ , Russell-Jones  R .  Mycosis fungoides with a CD56+ immunophenotype.   J Am Acad Dermatol. 2005;53(1):158-163. doi:10.1016/j.jaad.2005.01.133 PubMedGoogle ScholarCrossref
39.
Bakels  V , van Oostveen  JW , van der Putte  SC , Meijer  CJ , Willemze  R .  Immunophenotyping and gene rearrangement analysis provide additional criteria to differentiate between cutaneous T-cell lymphomas and pseudo-T-cell lymphomas.   Am J Pathol. 1997;150(6):1941-1949.PubMedGoogle Scholar
40.
Theodorou  I , Delfau-Larue  M , Bigorgne  C ,  et al. Cutaneous T-cell infiltrates: analysis of T-cell receptor gamma gene rearrangement by polymerase chain reaction and denaturing gradient gel electrophoresis.  Blood. 1995;86(1):305-310. PubMed
41.
Muche  JM , Lukowsky  A , Asadullah  K , Gellrich  S , Sterry  W .  Demonstration of frequent occurrence of clonal T cells in the peripheral blood of patients with primary cutaneous T-cell lymphoma.   Blood. 1997;90(4):1636-1642. doi:10.1182/blood.V90.4.1636.1636_1636_1642 PubMedGoogle ScholarCrossref
42.
Valipour  A , Jäger  M , Wu  P , Schmitt  J , Bunch  C , Weberschock  T .  Interventions for mycosis fungoides.   Cochrane Database Syst Rev. 2020;7:CD008946. doi:10.1002/14651858.CD008946.pub3PubMedGoogle Scholar
43.
Phan  K , Ramachandran  V , Fassihi  H , Sebaratnam  DF .  Comparison of narrowband UV-B with psoralen–UV-A phototherapy for patients with early-stage mycosis fungoides: a systematic review and meta-analysis.   JAMA Dermatol. 2019;155(3):335-341. doi:10.1001/jamadermatol.2018.5204 PubMedGoogle ScholarCrossref
44.
Lessin  SR , Duvic  M , Guitart  J ,  et al.  Topical chemotherapy in cutaneous T-cell lymphoma: positive results of a randomized, controlled, multicenter trial testing the efficacy and safety of a novel mechlorethamine, 0.02%, gel in mycosis fungoides.   JAMA Dermatol. 2013;149(1):25-32. doi:10.1001/2013.jamadermatol.541 PubMedGoogle ScholarCrossref
45.
Duvic  M , Martin  AG , Kim  Y ,  et al; Worldwide Bexarotene Study Group.  Phase 2 and 3 clinical trial of oral bexarotene (Targretin capsules) for the treatment of refractory or persistent early-stage cutaneous T-cell lymphoma.   Arch Dermatol. 2001;137(5):581-593.PubMedGoogle Scholar
46.
Bagot  M , Hasan  B , Whittaker  S ,  et al.  A phase III study of lenalidomide maintenance after debulking therapy in patients with advanced cutaneous T-cell lymphoma—EORTC 21081 (NCT01098656): results and lessons learned for future trial designs.   Eur J Dermatol. 2017;27(3):286-294. doi:10.1684/ejd.2017.3008 PubMedGoogle ScholarCrossref
47.
Querfeld  C , Rosen  ST , Guitart  J ,  et al.  Results of an open-label multicenter phase 2 trial of lenalidomide monotherapy in refractory mycosis fungoides and Sézary syndrome.   Blood. 2014;123(8):1159-1166. doi:10.1182/blood-2013-09-525915 PubMedGoogle ScholarCrossref
48.
Duvic  M , Kuzel  TM , Olsen  EA ,  et al.  Quality-of-life improvements in cutaneous T-cell lymphoma patients treated with denileukin diftitox (ONTAK).   Clin Lymphoma. 2002;2(4):222-228. doi:10.3816/CLM.2002.n.003 PubMedGoogle ScholarCrossref
49.
Child  FJ , Mitchell  TJ , Whittaker  SJ , Scarisbrick  JJ , Seed  PT , Russell-Jones  R ; Clinical and Experimental Dermatology.  A randomized cross-over study to compare PUVA and extracorporeal photopheresis in the treatment of plaque stage (T2) mycosis fungoides.   Clin Exp Dermatol. 2004;29(3):231-236. doi:10.1111/j.1365-2230.2004.01525.x PubMedGoogle ScholarCrossref
50.
Stadler  R , Otte  H-G , Luger  T ,  et al.  Prospective randomized multicenter clinical trial on the use of interferon-2a plus acitretin versus interferon-2a plus PUVA in patients with cutaneous T-cell lymphoma stages I and II.   Blood. 1998;92(10):3578-3581.PubMedGoogle Scholar
51.
Clarke  CA , Morton  LM , Lynch  C ,  et al.  Risk of lymphoma subtypes after solid organ transplantation in the United States.   Br J Cancer. 2013;109(1):280-288. doi:10.1038/bjc.2013.294 PubMedGoogle ScholarCrossref
52.
Mourad  A , Gniadecki  R .  Overall survival in mycosis fungoides: a systematic review and meta-analysis.   J Invest Dermatol. 2020;140(2):495-497.e5. doi:10.1016/j.jid.2019.07.712PubMedGoogle ScholarCrossref
53.
Li  JY , Pulitzer  MP , Myskowski  PL ,  et al.  A case-control study of clinicopathologic features, prognosis, and therapeutic responses in patients with granulomatous mycosis fungoides.   J Am Acad Dermatol. 2013;69(3):366-374. doi:10.1016/j.jaad.2013.03.036PubMedGoogle ScholarCrossref
54.
Kempf  W , Ostheeren-Michaelis  S , Paulli  M ,  et al; Cutaneous Lymphoma Histopathology Task Force Group of the European Organization for Research and Treatment of Cancer.  Granulomatous mycosis fungoides and granulomatous slack skin: a multicenter study of the Cutaneous Lymphoma Histopathology Task Force Group of the European Organization for Research and Treatment of Cancer (EORTC).   Arch Dermatol. 2008;144(12):1609-1617. doi:10.1001/archdermatol.2008.46 PubMedGoogle ScholarCrossref
55.
Rambhia  KD , Haldar  S , Dongre  AM , Khopkar  US .  Granulomatous slack skin with systemic involvement and a fatal outcome in an adolescent.   Clin Exp Dermatol. 2014;39(5):653-654. doi:10.1111/ced.12338 PubMedGoogle ScholarCrossref
56.
Gross  AM , Turner  J , Kirkorian  AY ,  et al.  A pediatric case of transformed mycosis fungoides in a BRCA2 positive patient.   J Pediatr Hematol Oncol. 2020;42(5):e361-e364. doi:10.1097/MPH.0000000000001481 PubMedGoogle ScholarCrossref
57.
Tronnier  M .  Foreign-body-associated granulomatous slack skin in folliculotropic mycosis fungoides of childhood.   J Cutan Pathol. 2009;36(5):578-581. doi:10.1111/j.1600-0560.2008.01072.x PubMedGoogle ScholarCrossref
58.
van Santen  S , Roach  RE , van Doorn  R ,  et al.  Clinical staging and prognostic factors in folliculotropic mycosis fungoides.   JAMA Dermatol. 2016;152(9):992-1000. doi:10.1001/jamadermatol.2016.1597 PubMedGoogle ScholarCrossref
59.
Akaraphanth  R , Douglass  MC , Lim  HW .  Hypopigmented mycosis fungoides: treatment and a 6 1/2-year follow-up of 9 patients.   J Am Acad Dermatol. 2000;42(1, pt 1):33-39. doi:10.1016/S0190-9622(00)90006-9 PubMedGoogle ScholarCrossref
60.
Stone  ML , Styles  AR , Cockerell  CJ , Pandya  AG .  Hypopigmented mycosis fungoides: a report of 7 cases and review of the literature.   Cutis. 2001;67(2):133-138.PubMedGoogle Scholar
61.
Khopkar  U , Doshi  BR , Dongre  AM , Gujral  S .  A study of clinicopathologic profile of 15 cases of hypopigmented mycosis fungoides.   Indian J Dermatol Venereol Leprol. 2011;77(2):167-173. doi:10.4103/0378-6323.77456 PubMedGoogle ScholarCrossref
62.
Rodney  IJ , Kindred  C , Angra  K , Qutub  ON , Villanueva  AR , Halder  RM .  Hypopigmented mycosis fungoides: a retrospective clinicohistopathologic study.   J Eur Acad Dermatol Venereol. 2017;31(5):808-814. doi:10.1111/jdv.13843 PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Close
Close

Lookup An Activity

or

My Saved Searches

You currently have no searches saved.

Close

My Saved Courses

You currently have no courses saved.

Close