2010 Volume 72 Issue 5 Pages 462-466
We report a case of a 66-year-old Japanese female. In 1995, an itchy erythematous plaque developed on her forehead. The plaque was recalcitrant to several kinds of topical ointments and new follicular papules developed on her neck. She was then referred to us in July 1997. Physical examination revealed a 3 × 2 cm slightly elevated erythematous plaque on her forehead and small red papules on her neck and back. A biopsy specimen from her forehead showed heavy lymphocytic infiltration in the hair follicles and the dermis without the involvement of the epidermis. Hair follicles were edematous and marked accumulation of mucin was observed. The diagnosis of follicular mucinosis was made, and the plaque disappeared after topical clobetasol propionate ointment treatment. In October 2007, she was admitted to our hospital on suspicion of autoimmune hepatitis. She was then referred to our department to diagnose dark red purple tumors on her cheek and lower jaw and neck. A biopsy specimen from the tumor of the lower jaw showed diffuse lymphocytic infiltration throughout the dermis and destruction of the follicles, and sheet-like growth of large atypical cells with cerebriform nuclei. A diagnosis of folliculotropic mycosis fungoides was finally made, which included her forehead plaque on her first visit.
