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December 2002

Mycosis Fungoides and Follicular Mucinosis—Reply

Author Affiliations

Not Available

Arch Dermatol. 2002;138(12):1614. doi:10.1001/archderm.138.12.1613

In reply

We thank Dr Vollmer for the thorough analysis of our data and interesting comments. Unfortunately, Dr Vollmer mixed up the diagnosis of a given disease with the outcome of the same disease. In fact, it is not surprising that a difference was found in the outcome between the 2 groups included in our study, as patients were divided according to the outcome, that is, presence or absence of clinicopathological signs of cutaneous T-cell lymphoma at presentation or during follow-up.1 In other words, it was impossible by the definition of our groups that a patient in the idiopathic FM group could ever die of lymphoma, and it is therefore a logical consequence that a Kaplan-Meier analysis of survival data should show the differences illustrated in the letter by Dr Vollmer. However, we specified that in 10 of our patients with lymphoma-associated FM, the initial diagnosis was idiopathic FM, and final categorization was achieved after a period variable between a few weeks and several years (patient 39, depicted in our Figure 7, is a telling example). We grouped the patients according to outcome because we wanted to check whether there were diagnostic criteria that would precisely identify patients with a different prognosis. Indeed, we have clearly shown that there are no clinicopathological criteria that allow clear-cut differentiation of idiopathic FM from lymphoma-associated FM, and suggested that idiopathic FM may represent a localized form of MF with an excellent prognosis.

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