Folliculotropic Mycosis Fungoides Complicated by Eosinophilia: A Case Report

    September 2011 in “ Chinese Journal of Dermatology ”
    Jun Song, Zhouwei Wu, Yue Sun, Guang-dou Zhu, Weimin Shi
    TLDR A man's skin condition was misdiagnosed and later identified as a rare type of skin cancer, which did not improve with treatment.
    A 69-year-old male patient experienced scattered erythema, follicular papules, acne-like lesions, and hair loss over the head, trunk, and limbs for 3 years, accompanied by peripheral blood eosinophilia. Histopathological examination revealed chronic inflammatory cell infiltration and capillary proliferation in the dermis, with eosinophils suggesting folliculitis. After treatment with antihistamines and antibiotics, the inflammation subsided. However, 3 months later, plaques with hair loss appeared on the occipital region, showing dense lymphocytic and eosinophilic infiltration, with atypical lymphocytes invading hair follicles. Immunohistochemistry was positive for CD3, CD4, CD5, CD2, CD43, and UCHL-1, but negative for T-cell receptor gene rearrangement. The diagnosis was folliculotropic mycosis fungoides. The patient was treated with PUVA and acitretin, but new lesions continued to appear, and the patient remained under follow-up.
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