Localized Syringolymphoid Hyperplasia with Alopecia and Anhidrosis

A female patient was diagnosed with localized syringolymphoid hyperplasia with alopecia and anhidrosis (SLHA) after 7 years of misdiagnoses and various treatments. She had a single, slowly progressing lesion on her right ankle characterized by brownish papules forming a hairless, sweatless erythematous patch. Histopathology revealed syringotropic T-cell infiltrates, supporting the view that SLHA is a syringotropic variant of mucinosis follicularis and a potential precursor to mycosis fungoides. Despite the progressive nature of the disease, no T-cell lymphoma developed during a 7-year follow-up. This case highlighted the diagnostic challenges of SLHA, necessitating collaboration between dermatologists and dermatopathologists.