Scarring Alopecia Due to Follicular MF
Report of Scarring Alopecia due to Follicular MF
Authors present the case of a 59-year-old male patient with extensive hair loss on the right side of the scalp. The patient had actually come to clinic for further treatment under a suspected diagnosis of alopecia areata. The authors report that the hair loss had been present for several years and was slowly worsening. The patient also reported the occasional appearance of firmly adhering scales in this area. There were no symptoms.
Further investigations, discussed below, showed that the patient did not have alopecia areata, but rather follicular mycosis fungoides (a type of skin cancer).
Hair Loss due to follicular mycosis fungoides mimicking alopecia areata. SOURCE: Kreutzer and Effendy. Cicatricial Alopecia Related to Folliculotropic Mycosis Fungoides. Dermatol Ther (Heidelb). 2020 Oct;10(5):1175-1180. used with creative commons license
Trichoscopy in follicular mycosis fungoides mimicking alopecia areata but with comedonal lesions SOURCE: Kreutzer and Effendy. Cicatricial Alopecia Related to Folliculotropic Mycosis Fungoides. Dermatol Ther (Heidelb). 2020 Oct;10(5):1175-1180. used with creative commons license
Comedones and cysts on abdomen in patient with follicular MF. SOURCE: Kreutzer and Effendy. Cicatricial Alopecia Related to Folliculotropic Mycosis Fungoides. Dermatol Ther (Heidelb). 2020 Oct;10(5):1175-1180. used with creative commons license
Biopsies from multiple sites showed FMF
Biopsies of the scalp, abdomen and lower leg showed epidermotropism and folliculotropism of lymphocytes with destruction of hair follicles consistent with MF. Mucin deposits were not present. Further olecular studies on the biopsy showed a T-cell receptor clone with the same rearrangement pattern at all three locations of biopsies
Treatment
Treatment was started with a combination therapy of topical class III steroids and PUVA. After 3 months of treatment, disease progression had stopped and some improvement of symptoms on trunk and limbs was noted.
REFERENCE
Kreutzer and Effendy. Cicatricial Alopecia Related to Folliculotropic Mycosis Fungoides. Dermatol Ther (Heidelb). 2020 Oct;10(5):1175-1180. used with creative commons license
This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.