Folliculotropic Mycosis Fungoides with Skewed T-cell Receptor CDR3 Motif: Suggestive of Lipid-antigen Selection?

The study investigated folliculotropic mycosis fungoides (FMF), a variant of mycosis fungoides, focusing on the role of antigens in hair follicles in its pathogenesis. Researchers analyzed T-cell receptor β gene sequences and dendritic cell subsets in 21 FMF patients and 20 control MF patients. They found a recurrent usage of TRBJ2-1 and TRBJ2-7 genes in FMF patients, contributing to a specific amino acid motif in the T-cell receptor's CDR3 region, previously associated with lipid-antigen stimulation. Immunohistochemical analysis showed abundant CD1c- and CD1a-expressing dendritic cells in FMF, supporting the hypothesis that lipid-antigen stimulation played a role in FMF.