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Background and Design: Primary cutaneous B-cell lymphomas (PCBCLs) have not been well characterized due to their relatively low incidence and heterogeneous clinical features. Materials and Methods: Data of 29 patients with primary cutaneous marginal zone lymphoma (PCMZL) (n=18), primary cutaneous follicle center B-cell lymphoma (PCFCL) (n=7), and primary cutaneous diffuse large B-cell lymphoma-leg type (PCDLBCL-LT) (n=4) who were followed and treated at Ankara University Faculty of Medicine between 2006 and 2022 were retrospectively evaluated. Clinical characteristics, treatment modalities, and outcomes of all patients were analyzed. Results: Our study supports the data that there are geographical differences in the distribution of B-cell lymphomas and that PCMZL is predominant in Asian countries compared to Europe. The mean age at the time of diagnosis in the PCDLBCL-LT group was significantly older than the indolent PCBCL group (p=0.022). The lesion size was predominantly less than 2 cm in PCMZL, between 2 and 5 cm in PCFCL, and larger than 5 cm in the PCDLBCL-LT group (p=0.006). While skin-directed treatments were the most common approach in the PCMZL and PCFCL groups, multi-agent chemotherapy was the preferred treatment in the PCDLBCL-LT group (p=0.003 and p=0.001, respectively). No significant correlation was found between age, gender, clinical features of the lesion, cutaneous lymphoma international prognostic index score, stage and treatment modalities, recurrence, and overall survival. The World Health Organization and European Organization for Research and Treatment of Cancer classification of cutaneous lymphoma remains the primary guideline for understanding the clinical behavior and prognostic parameters of this heterogeneous patient group. Conclusion: Given the relative rarity of these types of lymphoma, our patient collective provides an additional value to the existing literature.

Cutaneous leiomyosarcoma (CLMS), with an annual incidence of 0.2/100,000, is a very rare non-melanoma skin malignancy. CLMS has two subtypes: Dermal (primary) and subcutaneous; when diagnosed in the early period, the prognosis in the dermal type is better. CLMS is generally seen in the 6th and 7th decades of life and more frequently in the lower extremities and head and neck. Trauma, radiation, chemicals, and sun rays have been reported as the factors involved in its etiology. Epidermal cysts, skin metastases, dermatofibrosarcoma pro-tuberans, and keloid should be considered in the differential diagnosis of CLMS, which usually manifests as a nodular lesion. In the presented case, the lesion, which developed over scar tissue was diagnosed as keloid and treated accordingly for four years. The pathologic examination of dermal CLMS (d-CLMS) in this patient, in whom diagnosis was delayed, revealed invasion of the subcutaneous fat tissue, which is among the poor prognostic factors. Herein, we present a case with d-CLMS, in which early recognition is vitally important, who was treated for an extended period as keloid, and we emphasize the differential diagnosis in CLMS and pathological and dermatoscopic features that, to our knowledge, are being reported here for the first time.

Between 2015 and 2018, a clear increase was noticed in the cases of onychomycosis in which species of Aspergillus were cited as the cause while stimulating studies have been conducted. With this case, we call attention to the increasing frequency of Aspergillus niger onychomycosis in recent years and highlight the options for diagnosis and treatment as well as the risk factors and clinical and pathological properties of the disease.

The pathogenesis of mycosis fungoides (MF) is poorly understood, and an immunogenetic mechanism has been suggested to play a role. Human leukocyte antigen (HLA) class II alleles DRB1*11 and DQB1*03 were found to be significantly increased for patients with sporadic and/ or familial MF. The juvenile-onset familial MF is extremely rare. Herein, we report two siblings diagnosed with folliculotropic MF, both exhibiting similar morphology of a unilesional presentation on the flexural region of the arms. Both were positive for HLA-DRB1*04 and HLA-DQB1*03 alleles. The HLA-DQB1*03 allele has been described in familial MF in the literature recently, whereas “HLA-DRB1*04” allele has not been reported previously in familial MF cases.

Objective: Transformed mycosis fungoides (T-MF) is a rare variant of MF with an aggressive course. In this study, we aimed to describe characteristics of MF/Sezary syndrome (SS) patients with transformation. Materials and Methods: Patients diagnosed with T-MF among MF/ SS patients between 2000 and 2014 in a tertiary single center were evaluated retrospectively. Demographic data, clinical data, laboratory data, immunophenotype features, response to treatment, survival, and histopathologic features were analyzed. Results: Among 254 MF patients, 25 patients with T-MF were identified (10.2%) and included in the study. The male-to-female ratio was 2.6/1. The median time between MF diagnosis and transformation was 32 months (range: 0-192). Nine (36%) patients were diagnosed initially with T-MF. Advanced disease stage and high serum lactate dehydrogenase (LDH) levels were indicators of poor prognosis and treatment response. Five of the 18 patients with progressive disease had undergone allogeneic hematopoietic stem cell transplantation (allo-HSCT). Allo-HSCT resulted in complete remission in three (60%) patients. Ten (40%) patients died as a result of disease progression. Mean survival time was 25.2+-14.9 (2-56) months after transformation. Conclusion: Advanced stage, high serum LDH levels, and loss of CD26 and CD7 expression in the peripheral blood are poor rognostic factors in T-MF. Treatment-resistant tumors and nodules should be cautionary for T-MF. Patients with T-MF have a shortened survival. Some patients may respond to first-line treatments. However, the majority of patients who do not respond to first-line therapies also are unresponsive to second or third-line therapies. Allo-HSCT may be an alternative option in patients with T-MF.