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British Society for Investigative Dermatology Annual Meeting, University of Nottingham, 30 September to 1 October 1983

Sequential studies using monoclonal antibodies to membrane markers of T-cell subsets, Langerhans cells/indeterminate cells and HLA-Dr antigens were carried out on a total of fifty skin biopsies from fourteen patients with histologically proven mycosis fungoides (MF) and four with already suspected but histologically not yet proven MF. Frozen sections were treated with monoclonal antibodies to T-cell subsets, dendritic cells and HLA-Dr antigens using the peroxidase technique. A double staining technique was also used in some specimens. The immunopathological results closely parallel both the clinical picture and routine histological findings. In seventeen patients on PtJVA therapy, biopsies at least 48 hours post-treatment showed a reduction in the number of Langerhans cells/indeterminate cells in the epidermis compared with the pre-PUVA biopsy or our normal range, along with a decrease in the number of OKT4 + (helper) T lymphocytes and especially OKT8 + (suppressor/cytotoxic) lymphocytes. Staining of epidermal keratinocyte cell membranes with anti HLA-Dr of varying degree was seen in most biopsies, persisting in some after clinical and histological improvement was seen. Radiotherapy treatment received by two patients led to a decrease in both helper and suppressor lymphocytes in the dermis but only a slight reduction in the dendritic cell population in the epidermis. In four biopsies histologically only suspected of being MF the immunopathological results suggested early MF before histopathological findings were considered diagnostic. In each case the diagnosis was proven by clinical developments and subsequent biopsies. This study is the first to monitor the effects of PUVA and radiotherapy on all cell types considered to be involved in mycosis fungoides.