Clinicopathological features of mycosis fungoides in patients exposed to Agent Orange during the Vietnam War
The Journal of Dermatology, Exclusive Author Commentary  Clinical Article

Jang MS et al. – There are no reports on the clinicopathological features of mycosis fungoides (MF) among veterans exposed to Agent Orange, one of the herbicides used during the Vietnam War. To evaluate the clinical, histopathological and genotypic findings of Vietnam War veterans with MF and a positive history of exposure to Agent Orange, the authors performed a comparative clinicopathological study between MF patients with a history of Agent Orange exposure and those without a history of Agent Orange exposure. The results indicate that dermatologists should pay close attention to these clinicopathological differences. Careful assessment of history of exposure to defoliants is warranted in some cases suspicious for MF.

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First of all, thank you for your interest in our article. Agent Orange, one of the herbicides used during the Vietnam War, is shown to be related to several internal malignancies including non-Hodgkin’s lymphoma, lung cancer, and laryngeal cancer. However, there are no published reports of the correlation between Agent Orange exposure and the development of mycosis fungoides (MF), which occurs primarily in the skin, and no reports on the clinicopathologic features of MF among veterans exposed to Agent Orange. MF exposed to Agent Orange appears to differ both clinically and histologically from MF without exposure to Agent Orange, as shown in this comparative study. Significant differences were found in clinical characteristics (age of diagnosis, sex, symptom, morphology of the lesions). Moreover, the clinical lesions on exposed area accounted for a substantial proportion (46.7%) of total lesions. Histologically, irregular acanthosis was found more commonly than ordinary MF. Limitations of this study were the small number of patients and its retrospective nature. In addition, this study did not include epidemiologic assessment of MF patients in the general population who were exposed or not exposed to Agent Orange. Further epidemiologic investigation enrolling a large population are needed.

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