MYCOSIS FUNGOIDES VARIANTS
MYCOSIS FUNGOIDES VARIANTS
• Folliculotropic MF: With preferential involvement of head and neck, with or without mucinosis, degeneration of hair follicles (previously “mucinosis follicularis,” “alopecia mucinosa”) (Fig. 21-10).
• Hypopigmented MF: Hypopigmented patches in patients with dark skin.
• Pagetoid reticulosis (Woringer–Kolopp disease): This is a special variant of MF consisting of localized patches and plaques (Fig. 21-11), with a proliferation of neoplastic T cells that expand intraepidermally following a pattern similar to Paget disease. Extracutaneous dissemination has not been observed, and there is an excellent prognosis.
• Granulomatous slack skin: Rare subtype of MF with folds of lax skin in the major skin folds (Fig. 21-12).
• Sézary syndrome: A leukemic variant, see p. 493 and Section 8.
FIGURE 21-10 • Folliculotropic MF Multiple small follicular papules. This is called “mucinosis follicularis.”
FIGURE 21-11 • Pagetoid reticulosis This singular plaque in the groin of a 53-year-old woman looks like psoriasis with minimal scale. It was asymptomatic and had been present for 10 months. Histopathology revealed intraepidermal T cells in a pagetoid pattern.
FIGURE 21-12 • Granulomatous slack skin Firm, plate-like infiltrates on the neck and anterior chest and lax skin folds of the axillary and scapular region.