A case report of Folliculotropic mycosis fungoides: an aggressive variant of cutaneous T-cell lymphoma

Abstract

Folliculotropic mycosis fungoides (FMF) is a distinct variant of mycosis fungoides (MF) characterized by hair follicle epithelium infiltration by neoplastic lymphoid cells. Clinically, the lesions can present as papules or plaques with follicular prominence, acneiform lesions, comedones, cysts, and nodular prurigo-like lesions surrounding hair follicles. The disease-specific 5-year survival in case with FMF is equal to those with classical tumor stage MF but less than the cases with classical plaque stage MF. We report a case of 67-year-old man who presented with multiple erythematous follicular papules and plaques on the face, trunk and extremities which showed histopathologic, immunophenotypic findings of FMF. Laboratory work up showed high levels of lactate dehydrogenase and lymphocytosis. Computed tomography of chest and whole abdomen revealed no pulmonary nodules, no hepatosplenomegaly and no lymphadenopathy. Bone marrow biopsy showed moderately T-cell involved neoplasm. Based on these findings, the patient was diagnosed with FMF stage IVB (T3NxM0B2) and was referred to hematologist. The patient was given chemotherapy with CHOEP regimen with partial resolution of the lesions.