Follicular mycosis fungoides - A report of four Indian cases

<b>Background: </b> Follicular Mycosis Fungoides (FMF) is an under-recognized disease in India. Its clinical mimics include Hansen&#x2032;s disease and Sarcoidosis. <b> Aims:</b> To describe the clinical and pathological features of FMF. <b> Materials and Methods:&...

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Main Authors: Rajalakshmi T, Inchara Y, Antony Meryl
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2009-01-01
Series:Indian Journal of Medical and Paediatric Oncology
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Online Access:http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=3;spage=108;epage=112;aulast=Rajalakshmi
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author Rajalakshmi T
Inchara Y
Antony Meryl
author_facet Rajalakshmi T
Inchara Y
Antony Meryl
author_sort Rajalakshmi T
collection DOAJ
description <b>Background: </b> Follicular Mycosis Fungoides (FMF) is an under-recognized disease in India. Its clinical mimics include Hansen&#x2032;s disease and Sarcoidosis. <b> Aims:</b> To describe the clinical and pathological features of FMF. <b> Materials and Methods:</b> All cases of FMF between January and December 2007 were retrieved. Cases of conventional epidermotropic MF with a minor follicular component were excluded. Slides were reviewed by two observers. The following criteria were assessed: degree and density of folliculotropism of lymphocytes, location of folliculotropism (infundibular / isthmic / bulbar), follicular mucin, eosinophils, granulomas, and conventional epidermotropism. Each feature was assigned a semi-quantitative grade. <b> Results:</b> There were four cases of FMF, with an equal gender distribution and a mean age of 17.5 years. All lesions were on the face. They presented as: hypopigmented patches (2) and erythematous plaques (2). Alopecia was seen in two cases. The clinical diagnosis was Hansen&#x2032;s disease in all four, with a differential of Alopecia mucinosa / Sarcoidosis in two cases.The histological features seen were: disproportionate folliculotropism, lymphocyte tagging with haloes, follicular mucin, and nucleomegaly / convolution in all four cases, prominent eosinophils (2), epithelioid granulomas (1), eccrine infiltration (4), parakeratosis at the follicular ostia (2), and sebaceotropism (1). The infiltrate was bulbar (4) and isthmic (2). The rest of the epidermis showed no hint of conventional MF. <b> Conclusion:</b> The preferential features for FMF were involvement of face, dominant folliculotropism, nuclear atypia and convolution, and follicular mucin. Presence of granulomas and eosinophils necessitated exclusion of infectious causes. The absence of findings of MF in the rest of the epidermis should not deter pathologists from rendering this diagnosis.
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spelling doaj-art-e6b3db550f7f4d5c9d333252a26daa7b2025-08-20T02:25:48ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Medical and Paediatric Oncology0971-58510975-21292009-01-01303108112Follicular mycosis fungoides - A report of four Indian casesRajalakshmi TInchara YAntony Meryl<b>Background: </b> Follicular Mycosis Fungoides (FMF) is an under-recognized disease in India. Its clinical mimics include Hansen&#x2032;s disease and Sarcoidosis. <b> Aims:</b> To describe the clinical and pathological features of FMF. <b> Materials and Methods:</b> All cases of FMF between January and December 2007 were retrieved. Cases of conventional epidermotropic MF with a minor follicular component were excluded. Slides were reviewed by two observers. The following criteria were assessed: degree and density of folliculotropism of lymphocytes, location of folliculotropism (infundibular / isthmic / bulbar), follicular mucin, eosinophils, granulomas, and conventional epidermotropism. Each feature was assigned a semi-quantitative grade. <b> Results:</b> There were four cases of FMF, with an equal gender distribution and a mean age of 17.5 years. All lesions were on the face. They presented as: hypopigmented patches (2) and erythematous plaques (2). Alopecia was seen in two cases. The clinical diagnosis was Hansen&#x2032;s disease in all four, with a differential of Alopecia mucinosa / Sarcoidosis in two cases.The histological features seen were: disproportionate folliculotropism, lymphocyte tagging with haloes, follicular mucin, and nucleomegaly / convolution in all four cases, prominent eosinophils (2), epithelioid granulomas (1), eccrine infiltration (4), parakeratosis at the follicular ostia (2), and sebaceotropism (1). The infiltrate was bulbar (4) and isthmic (2). The rest of the epidermis showed no hint of conventional MF. <b> Conclusion:</b> The preferential features for FMF were involvement of face, dominant folliculotropism, nuclear atypia and convolution, and follicular mucin. Presence of granulomas and eosinophils necessitated exclusion of infectious causes. The absence of findings of MF in the rest of the epidermis should not deter pathologists from rendering this diagnosis.http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=3;spage=108;epage=112;aulast=RajalakshmiAlopecia mucinosafollicular mucinosisfollicular mycosis fungoides
spellingShingle Rajalakshmi T
Inchara Y
Antony Meryl
Follicular mycosis fungoides - A report of four Indian cases
Indian Journal of Medical and Paediatric Oncology
Alopecia mucinosa
follicular mucinosis
follicular mycosis fungoides
title Follicular mycosis fungoides - A report of four Indian cases
title_full Follicular mycosis fungoides - A report of four Indian cases
title_fullStr Follicular mycosis fungoides - A report of four Indian cases
title_full_unstemmed Follicular mycosis fungoides - A report of four Indian cases
title_short Follicular mycosis fungoides - A report of four Indian cases
title_sort follicular mycosis fungoides a report of four indian cases
topic Alopecia mucinosa
follicular mucinosis
follicular mycosis fungoides
url http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=3;spage=108;epage=112;aulast=Rajalakshmi
work_keys_str_mv AT rajalakshmit follicularmycosisfungoidesareportoffourindiancases
AT incharay follicularmycosisfungoidesareportoffourindiancases
AT antonymeryl follicularmycosisfungoidesareportoffourindiancases