Underrecognized clinical features of folliculotropic mycosis fungoides: a large clinical series. (27th February 2017)

• Record Type: Journal Article
• Authors: Baykal, Can; Atci, Tugba; Ozturk Sari, Sule; Polat Ekinci, Algun; Buyukbabani, Nesimi
• Is Part Of: Journal der Deutschen Dermatologischen Gesellschaft. Volume 15:Number 3(2017)
• Page Start: 289
• Page End: 299
• Publication Date: 2017-02-27
• Subjects: Skin -- Diseases -- Periodicals; Dermatology -- Periodicals; 616.5005
• DOI: 10.1111/ddg.12976
• Languages: English
• ISSNs: 1610-0379

Abstract

Summary: Background and Objective: A rare variant of mycosis fungoides (MF), folliculotropic MF (FMF) is characterized by a broad clinical spectrum that primarily includes follicle‐based lesions but also many atypical clinical manifestations. The objective of the present study was to conduct a clinical analysis of patients with FMF, with a particular focus on highlighting underrecognized dermatological features. Patients and Methods: Overall, 27 FMF patients enrolled in our department';s MF registry, which includes 572 patients, were retrospectively reevaluated with regard to demographics, clinical features, treatment modalities, follow‐up, and outcomes. Results: Besides the well‐known clinical features of FMF, we found lichen spinulosus‐like lesions in association with hypopigmentation (n = 3) and alopecia (n = 2), infiltrated/elevated erythematous facial plaques initially considered to be lupus tumidus (n = 2), pseudotumoral lesions clinically mimicking tumor‐stage MF (n = 1), persistent excoriations (n = 1) and erythematous facial papules mimicking rosacea (n = 1), as well as white dome‐shaped asymptomatic papules/nodules filled with mucin (on histology) (n = 2) that overlay other disease‐related lesions. Various therapeutic methods were used with variable results. Eight (29.6 %) patients had late‐stage disease. Conclusions: Awareness of underrecognized clinical manifestations may be key to reducing delayed diagnosis of this aggressive MF variant.