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Gabriele Roccuzzo,* Luca Mastorino,* Giuseppe Gallo, Paolo Fava, Simone Ribero, Pietro Quaglino Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy*These authors contributed equally to this workCorrespondence: Giuseppe Gallo, Department of Medical Sciences, Section of Dermatology, University of Turin, Via Cherasco 23, Torino, Turin, 10126, Italy, Tel +39 0116335843 ; +39 0116335034, Email giuseppegallomd@gmail.comIntroduction: Folliculotropic mycosis fungoides (FMF) is the most frequent variant of mycosis fungoides (MF), with clinical features which differ from the classic form. As for therapeutic options, the latest guidelines on MF agree on a stage-driven strategy, in consideration of clinical presentation, symptom burden and patient’s comorbidities.Materials and Methods: A search on MEDLINE, PubMed, Scopus and Cochrane Library was conducted to gather the latest evidence on FMF clinical management. Manuscripts published in the last five years (January 2017–April 2022) were included. Our single-center experience was also described.Results: A total of 15 articles were analyzed, with a total of 432 patients (disease stage from IA to IVA2). The most widely-used treatment was psoralen ultra-violet A (PUVA) in monotherapy or in association with other drugs. Oral retinoid-based therapy was also described as a therapeutic option alone or in combination. Other therapy reported were based on Brentuximab Vedotin, Mogamulizumab, Carmustine, topical steroids, tazarotene and excimer laser, interferon, nitrogen mustard, imiquimod, systemic chemotherapy, extracorporeal photopheresis and stem cell transplantation.Discussion: FMF is characterized by specific clinical-pathologic features. Advanced forms assume characteristics more similar to classic MF (infiltrated plaques and nodules), whilst early stages can present in a wide range of clinical forms (acneiform lesions, follicular-like keratoses, erythematous patches). As for therapeutic options, in absence of specific guidelines, a high number of treatments are described in clinical practice, with variable results. Phototherapy in all its forms, especially as PUVA, appears to have the greatest initial therapeutic success. Retinoids, although widely used, appear to be poorly effective in monotherapy, particularly acitretin. Combination treatment with phototherapy seems to be advisable. Ionizing treatments, such as radiotherapy and TSEBT, appear effective, at least in the short term. Overall, an integrated approach is mandatory for the inconstant course of the disease and its multidisciplinary nature.Keywords: mycosis fungoides, folliculotropic mycosis fungoides, cutaneous lymphoma, primary cutaneous T-cell lymphoma, therapy

Introduction: Anorectal melanoma (ARM) is rare and highly lethal neoplasm. It has a poorer prognosis compared with cutaneous ones. Sentinel lymph node biopsy (SLNB) has become the preferred method of nodal staging method for cutaneous melanoma. The role of SLNB for staging of anal melanoma remains unclear. This study investigates SLN identification and biopsy in patients with ARM. Methods and patients: We present our experience of patients affected by ARM who underwent to SLNB. Clinical workup included digital rectal examination, anoscopy, rigid proctoscopy, total body (computed tomography) CT scan, pelvic magnetic resonance imaging (MRI), and fludeoxyglucose-18-positron emission tomography-CT (FDG-PET-CT) to obtain an adequate pretreatment staging of the patients. Wide local excision and contemporary SLNB were performed to remove primary neoplasm and detect inguinal lymph node metastases. Results: In total, five female patients, median age 68 years, were included. All were affected by anal melanoma. Detection rate of SLNB was 100% and scintigraphic migration was unilateral in three patients and bilateral in the other two. Definitive inguinal histological exam revealed unilateral metastases in three patients, bilateral metastases in one case, and the presence of isolated neoplastic cells in the remaining case. SLNB allowed a diagnostic upgrading of inguinal metastases in three of five patients (60%), permitting better staging and further appropriate treatment. Conclusions: Our experience demonstrates SLN biopsy is a minimally invasive, cost-effective, and rapid procedure for accurately staging patients with clinically occult disease. In fact, SLNB emerges as an appropriate procedural tool to identify patients with occult lymph node metastases who could undergo immune or target therapy, as well as to avoid unnecessary inguinal lymph node dissection for patients who would not benefit. [ABSTRACT FROM AUTHOR]

Mogamulizumab is a first‐in‐class IgG1k monoclonal antibody that selectively targets the chemokine receptor type 4. The drug has received Food and Drug administration authorisation for mycosis fungoides and Sézary syndrome following failure of at least one previous course of systemic therapy and now is available in Europe. One of the most common treatment‐related side effects observed has been the mogamulizumab‐associated rash (MAR), which affects up to a quarter of patients and is the most frequent adverse event leading to drug discontinuation. The aim of this study is to perform a systematic review of the literature on patients diagnosed with MAR and other mogamulizumab‐related cutaneous events to describe the clinical and histological characteristics, the management in clinical practice and to assess whether these events have prognostic implications. In total, 2073 records were initially identified through a literature search, 843 of which were duplicates. After screening for eligibility and inclusion criteria, 49 articles reporting mogamulizumab‐associated cutaneous events were included. Totally, 1516 patients were retrieved, with a slight male prevalence as for the available data (639 males and 570 females, i.e. 52.9% vs. 47.1%). Regarding the reported clinicopathological findings of the cutaneous reactions, the five most common patterns were spongiotic/psoriasiform dermatitis (22%), eruptions characterized by the presence of papules and/or plaques (16.1%), cutaneous granulomatosis (11.4%), morbilliform or erythrodermic dermatitis (9.4%) and photodermatitis (7.1%). Our results highlight how the majority of the reported cutaneous adverse events on mogamulizumab are of mild‐to‐moderate entity and generally manageable in clinical practice, though prompt recognition is essential and case‐by‐case assessment should be recommended. Future research will need to focus on the MAR prognostic implications and to identify genomic and molecular markers for a more rapid and accurate diagnosis. [ABSTRACT FROM AUTHOR]