Elucidating the Relationship Between Mycosis Fungoides and Contact Sensitization: A Retrospective Study

Background: Mycosis fungoides (MF), a type of cutaneous T cell lymphoma (CTCL), presents diagnostic challenges due to its complex etiology. Previous studies suggest a link between MF and type IV hypersensitivity, particularly allergic contact dermatitis (CD), but conclusive evidence is lacking. Objective: To investigate the relationship between MF and contact sensitization, focusing on positive patch test (PPT) results in a controlled, extensive study. Methods: A retrospective case-control study comparing 84 MF patients with 168 control patients carefully matched for demographics and clinical parameters. All participants underwent patch testing at Sourasky Medical Center Dermatology Clinic. Hypersensitivity reactions were analyzed to explore their association with MF. Results: Our study, the largest of its kind, found a statistically significant difference in PPT reactions between the 2 groups (P < 0.001). MF patients had a markedly lower prevalence of positive reactions compared with the control group. Fragrance mix emerged as a common allergen in MF patients, contrasting with methylchloroisothiazolinone-methylisothiazolinone in the control group. Conclusions: This study shows a lower prevalence of hypersensitivity reactions in MF patients and identifies fragrance mix as a prevalent allergen. These findings suggest reevaluating the role of contact sensitization in MF pathophysiology and underscore the need for further research on diagnostic markers and therapeutic targets.