Folliculotropic Mycosis Fungoides with Comedonal-like Appearances

Folliculotropic mycosis fungoides (FMF) is a variant of mycosis fungoides characterized by the presence of folliculotropic atypical Tcells infiltrates, often with sparing of the epidermis and preferential involvement of the head and neck. Since the original designation of folliculotropic mycosisfungoides (FMF) is a distinct entity, there has been an increasing appreciation of the broad clinical and histopathology spectrum, which can present in this disease. In July 2013, a 37-year-old male from Tehran (Iran) who had complained of 9 months of progressive erythematous follicular patches and plaques on the trunk and comedones and acne like lesions on his forehead has been referred to us. The histopathology study showed perifollicular and intrafollicular lymphoid cells infiltration predominantly. There was no histopathology evidence of dermal mucin deposit (PAS negative) and alopeciaor syringotropism T cell infiltration. The immunohistochemical analysis was positive for CD3 and D4. The patients received different treatments based on the stage of their disease. FMF should be considered in patients who present with alopecia, acne like lesions, cysts and comedones in older ages with a spectrum of histologic changes. We emphasize for any time it should be under-recognized.