{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T15:27:57Z","timestamp":1787153277846,"version":"build-2736575974"},"reference-count":27,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"\n Importance<\/jats:title>\n Hypopigmented mycosis fungoides (HMF) is uncommon in adults, and data on clinicopathologic features and long-term outcomes remain sparse.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the clinicopathologic features and outcomes of adults with HMF in a large multicenter cohort.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective multicenter cohort study conducted from January 2011 to October 2023 at 6 US tertiary referral centers and included adults (18 years or older at diagnosis) with biopsy-confirmed HMF and hypopigmentation documented at diagnosis, with a median (range) follow-up of 39 (1-347) months. Data were analyzed from February to December 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n \n Clinical variant, immunophenotype predominance, and polymerase chain reaction\u2013based T-cell receptor (\n TCR<\/jats:italic>\n ) gene rearrangement in peripheral blood and\/or skin.\n <\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Best overall response, defined as complete response, partial response, stable disease, or progressive disease, and progression to a higher stage.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The cohort included 224 adults with HMF (median [range] age, 44 [18-74] years), of whom 164 (73%) were women (60 men [27%]), 5 (2%) were Asian individuals, 1 (0.4%) was a Hispanic\/Latino individual, 1 (0.4%) was a Middle Eastern individual, 19 (8%) were White individuals, and 186 (83%) were Black individuals; 219 (98%) presented with early-stage disease. Most had hypopigmented lesions only (159 [71%]), whereas 65 (29%) exhibited mixed-variant mycosis fungoides; outcomes were similar between groups. Among 141 patients with available immunophenotyping, 88 (63%) had CD8-positive predominance. Among 207 treated patients, most (179 [90%]) received skin-directed therapy alone. Among 198 evaluable patients, the best overall response was complete response for 52 (26%), partial response for 101 (51%), stable disease for 34 (17%), and progressive disease for 11 (6%). Over a median (range) follow-up of 39 (1-347) months, 14 of 224 patients (6%) experienced progression to a higher stage, including 5 of 219 patients (2%) with early-stage disease at baseline who experienced progression to advanced-stage disease. Peripheral blood\n TCR<\/jats:italic>\n monoclonality was detected in 23 of 85 tested patients (27%) and was associated with poorer treatment response but not with disease progression.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n \n The finding of this cohort study suggest that adult HMF demonstrated a generally indolent course, with favorable response to skin-directed therapy, irrespective of immunophenotype or mixed-variant presentation. Peripheral blood\n TCR<\/jats:italic>\n monoclonality was associated with lower treatment response but not disease progression.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamadermatol.2026.1793","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T15:30:47Z","timestamp":1781710247000},"page":"780","source":"Crossref","is-referenced-by-count":0,"title":["Clinicopathologic Features and Long-Term Outcomes of Adult Hypopigmented Mycosis Fungoides"],"prefix":"10.1001","volume":"162","author":[{"given":"Jong Bin","family":"Park","sequence":"first","affiliation":[{"name":"Department of Dermatology, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamir","family":"Geller","sequence":"additional","affiliation":[{"name":"Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New 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Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Pierog","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Leibovit-Reiben","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Mayo Clinic Arizona, Scottsdale"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron R.","family":"Mangold","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Mayo Clinic Arizona, Scottsdale"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Scribner","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sai M.","family":"Talluru","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa L.","family":"Stockard","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Mayo Clinic Arizona, Scottsdale"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna","family":"Vroman","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Weiner","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela B.","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Emory 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