PA13: A Hair’s Breadth from Misdiagnosis

June 2024 in “ British Journal of Dermatology ”

Niamh Kearney, Nicholas Stefanovic, Gregg Murray, Kevin Molloy, Richard Watchorn

hair loss skin changes nonspecific lymphocytic folliculitis folliculotropic mycosis fungoides FMF patch-stage disease mSWAT score mometasone furoate keratosis pilaris

TLDR A 15-year-old boy was correctly diagnosed with a rare skin condition after initially being misdiagnosed.

A 15-year-old boy with a 2-year history of hair loss and skin changes was initially misdiagnosed with nonspecific lymphocytic folliculitis. Further histopathological review and expert opinion confirmed a diagnosis of folliculotropic mycosis fungoides (FMF), a rare condition in pediatric patients. The patient exhibited patch-stage disease with a modified Severity-Weighted Assessment Tool (mSWAT) score of 3.9, without lymphadenopathy or B symptoms. Treatment with mometasone furoate 0.1% was initiated, and further investigations are planned. This case underscores the importance of considering FMF in pediatric patients with lesions resembling keratosis pilaris in unusual distributions.

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