Cicatricial Alopecia Related to Folliculotropic Mycosis Fungoides
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CASE REPORT
Cicatricial Alopecia Related to Folliculotropic Mycosis Fungoides Katharina M. Kreutzer . Isaak Effendy
Received: June 1, 2020 Ó The Author(s) 2020
ABSTRACT Key Summary Points Folliculotropic mycosis fungoides (FMF) is a particular subtype of mycosis fungoides (MF), characterized by an infiltration of neoplastic CD4? T cells in the epidermis which can spread to all follicular structures, sebaceous glands, sweat glands and hair follicles. Clinically, FMF can exhibit various cutaneous symptoms. However, these symptoms often occur on the scalp, face and neck, which are rarely affected by conventional MF. We report cicatricial alopecia in a patient with FMF as alopecia lymphomatica. This peculiar symptom should be kept in mind as a critical differential diagnosis of scarring alopecia, leading to further investigation. Thus, an early diagnosis of FMF may be obtained.
Keywords: Alopecia lymphomatica; Cutaneous T-cell lymphoma; Folliculotropic mycosis fungoides; Hair loss; Scarring alopecia
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12674471. K. M. Kreutzer I. Effendy (&) Department of Dermatology and Allergology, Municipal Hospital of Bielefeld, Academic Teaching Hospital of the University of Muenster, Bielefeld, Germany e-mail: [email protected]
Folliculotropic mycosis fungoides (FMF) is a rare, but potentially aggressive subtype of a cutaneous T-cell lymphoma (CTCL). It occurs particularly in men, and can frequently involve the scalp, face, and neck. One eye-catching manifestation of FMF is scarring alopecia. It is generally assumed that the prognosis of FMF is worse than that of classical MF. An early detection of FMF is hence generally to be pursued, since it concerns CTCL with possible serious consequences. In any case of alopecia, a dermoscopic examination should first be made, and if the source of scarring alopecia is still unclear, a skin biopsy is needed to clarify the cause of hair root destruction, because FMF may be hidden behind a scarring alopecia. The prognosis of FMF ranges from indolent localized cutaneous T-cell lymphoma to aggressive generalized tumor growth. Lifelong clinical controls are recommended.
Dermatol Ther (Heidelb)
INTRODUCTION Mycosis fungoides (MF), the most common cutaneous T-cell lymphoma (CTCL), typically presents in its early stage as inflammatory erythematous patches or plaques. Epidermotropism is the histopathologic hallmark of the disease. The rather harmless early stage can persist for a long time before it relatively rarely turns into a tumor stage. Folliculotropic mycosis fungoides (FMF) is a quite rare, but aggressive subtype of MF [1, 2]. It is found more often in men, and frequently involves the scalp, face, and neck, which are usually spared in conventional MF. FMF typically comes with a wide spectrum of symptoms [3], which makes diagnosis sometimes difficult. One eye-catching manifestation is scarring alopecia, which is often accompanied by loss of eyebrow hair [4]. Keeping that
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