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- Title
Folliculotripic mycosis fungoides with large-cell transformation presenting as dissecting cellulitis of the scalp.
- Authors
Gilliam, Anita C.; Lessin, Stuart R.; Wilson, Darren M.; Salhany, Kevin E.
- Abstract
Follicular mycosis fungoides (MF) is a rare variant of cutaneous T-cell lymphoma (CTCL) in which malignant lymphocytes preferentially infiltrate hair follicles. This report describes a patient with follicular mycosis fungoides presenting in a manner similar to dissecting cellulitis of the scalp with nonhealing, draining nodular lesions. Follicular mucinosis associated with folliculotropic mycosis fungoides resulted in follicular disruption and deep dissecting cellulitis. Large-cell transformation of CTCL was present in the initial diagnostic scalp and axillary lymph node specimens. The patient died from progressive CTGL 9 months following initial diagnosis despite electron beam radiation, topical mechlorethamine, interferon-α, and systemic chemotherapy. This case indicates that large-cell transformation of folliculotropic mycosis fungoides is an aggressive form of CTCL, and that folliculotropic mycosis fungoides can give rise to lesions which resemble dissecting cellulitis of the scalp. Upregulation of intercellular adhesion molecule-1 (ICAM-1) on follicular epithelium adjacent to lymphocyte function-associated antigen-1 (LFA-1 )-positive folliculotropic lymphoma cells in this report provides insight into lymphocyte homing mechanisms in folliculotropic MF.
- Subjects
MYCOSIS fungoides; LYMPHOCYTES; HAIR follicles; CELLULITIS; SCALP; LYMPH nodes; ANTIGENS; DRUG therapy
- Publication
Journal of Cutaneous Pathology, 1997, Vol 24, Issue 3, p169
- ISSN
0303-6987
- Publication type
Article
- DOI
10.1111/j.1600-0560.1997.tb01572.x