A case of folliculotropic mycosis fungoides successfully treated with a combination of oral retinoid and oral PUVA

Abstract

A 74－year－old woman developed pruritic, skin－colored papules on her posterior neck approximately three years prior to her initial visit. The area of the papules had expanded by the time the patient visited our hospital. Histopathological examination revealed infiltration of lymphocytes with varying nuclear sizes within and around the hair follicles, as well as dense infiltration of inflammatory cells, including neutrophils and eosinophils. Alcian blue staining was positive in the clefts surrounding the hair follicles, indicating mucin deposition. Based on clinical and histopathological findings, the patient was diagnosed with folliculotropic mycosis fungoides (FMF). FMF shows more treatment-resistance and poorer prognosis than classical MF. Treatment with PUVA alone is unlikely to be effective ; however, treatment with PUVA in combination with oral retinoids or intravenous interferons may be effective. In this case, PUVA combined with oral retinoids was effective.[Skin Cancer (Japan) 2024 ; 39 : 318－323]