To our knowledge, this is the largest follow-up study on LA and its relationship to MF. Our data show that 9 patients (39%) had persistent skin disease after a mean follow-up of 102.1 months. However, there were no substantial changes in the clinical picture, and classic MF developed in none of these patients. In the literature, an association between PPPD (including LA, Shamberg disease, and other variants difficult to classify) and MF, as well as progression of PPPD to MF, is reported.4,10,17- 19 In this context, it is notable that the first patient with LA described in the American literature subsequently died of MF.20 In the study by Toro and coworkers,11 histopathologic examination and analysis of the T-cell receptor gene rearrangement in 56 patients with PPPD raised the suspicion that this condition is biologically related to MF. Barnhill and Braverman7 described 3 patients with PPPD evolving to MF during follow-up periods averaging 8.4 years. Lipsker et al21 evaluated 17 patients who were diagnosed clinically and histologically as having chronic pigmented purpura. Two of these patients developed cutaneous T-cell lymphoma within a few years. However, our results indicate that conventional cases of LA have an excellent prognosis and do not eventuate into MF. Viseux et al22 describe a patient with PPPD who developed MF after 24 years, but lesions in our patients were stable or regressed spontaneously, a finding that would be unusual for classic MF. In fact, 5 patients had skin lesions that resolved without any treatment and did not recur during the follow-up period (range, 37-168 months), indicating possible spontaneous resolution of the disease. Although lesions of MF can regress spontaneously as well, recurrences are the rule. However, the median follow-up period (76 months) among our patients may be too short to completely rule out the possibility of evolution to MF.