Document Type : Case Report(s)
Authors
Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
Folliculotropic mycosis fungoides (FMF) is a rare variant of cutaneous T-cell lymphoma which is categorized as a separate entity. In histopathology, malignant lymphocytes selectively surround and infiltrate hair follicles. FMF has different clinical features in comparison with classic MF which is more refractory to treatment and has a worse prognosis.
In the current study, we describe a 42-year-old patient presenting as follicular papules with keratotic spines and alopecia on the scalp, face, and trunk. Histologic examination of the patient’s biopsy revealed follicular and perifollicular T lymphoid cell infiltration without follicular mucinosis. Clonality analysis was interpreted as CD4+ T cell lymphoproliferative disorder. With the final diagnosis of FMF, the patient underwent treatment with oral acitretin and topical corticosteroid and psoralen plus ultraviolet A (PUVA). This case, in addition to the accompanied review of literature, revealed the importance of considering FMF in spiny hyperkeratotic papules in seborrheic areas refractory to antifungal treatments.
Keywords
Shatila Torabi (Google Scholar)
Farnaz Ahmadpour (PubMed)
How to cite this article:
Torabi S, Fakhraei S, Tayebi Meibodi N, Ahmadpour F. Spiny hyperkeratosis-like follicular mycosis fungoides: a case report. Middle East J Cancer. 2023;14(3):457-62. doi: 10.30476/ mejc.2022.94274.1719.
- Bolognia J, Jorizzo J, Schaffer J, Callen J, Cerroni L, Heymann W, et al. Bolognia textbook of dermatology. Spain: Mosby Elsevier publishing; 2012.
- Van Doorn R, Scheffer E, Willemze R. Follicular Mycosis fungoides, a distinct disease entity with or without associated follicular mucinosis: A clinicopathologic and follow-up study of 51 patients. Arch Dermatol. 2002;138(2):191-8. doi: 10.1001/archderm.138.2.191.
- DeBloom J 2nd, Severson J, Gaspari A, Scott G. Follicular mycosis fungoides: a case report and review of the literature. J Cutan Pathol. 2001;28(6):318-24. doi: 10.1034/j.1600-0560.2001.028006318.x.
- Passos PC, Zuchi MF, Fabre AB, Martins LE. Follicular mucinosis-case report. An Bras Dermatol. 2014;89:337-9. doi: 10.1590/abd1806-4841.20142968.
- Francis GJ, Silverman AR, Saleh O, Lee GJ. Follicular mycosis fungoides associated with lithium. J Am Acad Dermatol. 2001;44(2):308-9. doi: 10.1067/mjd.2001.110044.
- Willemze R, Jaffe ES, Burg Gn, Cerroni L, Berti E, Swerdlow SH, et al. WHO-EORTC classification for cutaneous lymphomas. Blood. 2005;105(10):3768-85. doi: 10.1182/blood-2004-09-3502.
- Van Santen S, Roach REJ, van Doorn R, Horváth B, Bruijn MS, Sanders CJG, et al. Clinical staging and prognostic factors in folliculotropic mycosis fungoides. JAMA Dermatol. 2016;152(9):992-1000. doi: 10.1001/jamadermatol.2016.1597
- Hodak E, Amitay-Laish I, Atzmony L, Prag-Naveh H, Yanichkin N, Barzilai A, et al. New insights into folliculotropic mycosis fungoides (FMF): A single-center experience. J Am Acad Dermatol. 2016;75(2):347-55. doi: 10.1016/j.jaad.2016.03.009.
- Demirkesen C, Esirgen G, Engin B, Songur A, Oğuz O. The clinical features and histopathologic patterns of folliculotropic mycosis fungoides in a series of 38 cases. J Cutan Pathol. 2015;42(1):22-31. doi: 10.1111/cup.12423.
- Van Santen S, Jansen PM, Quint KD, Vermeer MH, Willemze R. Plaque stage folliculotropic mycosis fungoides: histopathologic features and prognostic factors in a series of 40 patients. J Cutan Pathol. 2020;47(3):241-50. doi: 10.1111/cup.13615.
- Van Doorn R, Van Haselen CW, van Voorst Vader PC, Geerts ML, Heule F, de Rie M, et al. Mycosis fungoides: Disease evolution and prognosis of 309 Dutch patients. Arch Dermatol. 2000;136(4):504-10. doi: 10.1001/archderm.136.4.504.
- Gerami P, Rosen S, Kuzel T, Boone SL, Guitart J. Folliculotropic mycosis fungoides: An aggressive variant of cutaneous T-cell lymphoma. Arch Dermatol. 2008;144(6):738-46. doi: 10.1001/archderm.144.6.738.
)