Mycosis fungoides bullosa: An unusual presentation of a rare entity

Ahmad Nofal,Rania Alakad,Rana Ehab,Reham Essam

doi:10.1016/j.jdcr.2021.10.019

Abstract

Mycosis fungoides bullosa: An unusual presentation of a rare entity

Highlights

Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma with an incidence of 6 cases per million per year.[1]
We present a male patient with generalized vesiculobullous MF
According to Bowman et al,[6] the diagnosis is made by the presence of the following: (1) Vesiculobullous lesions 6 typical lesions of MF; (2) typical histologic features of MF with

Summary

INTRODUCTION

Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma with an incidence of 6 cases per million per year.[1]. Skin biopsies were taken from the plaques and bullae Histologic examination revealed both intraepidermal and subepidermal blisters, along with infiltration of the upper dermis and dermo-epidermal junction by atypical lymphocytes with migration into the epidermis (epidermotropism) (Fig 2, A). Direct immunofluorescence for IgG, IgA, immunoglobulin M, and C3 was negative Based on these findings, the diagnosis of vesiculobullous MF was made. Histologic examination of the nodule showed diffuse atypical lymphoid infiltrate involving the full thickness of the dermis and extending to the subcutaneous tissue (Fig 3, B). Despite aggressive therapy including cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisolone, the condition rapidly progressed with continuous appearance of new lesions and tumors, resulting in death of the patient less than 1 year after the onset of the bullous lesions

DISCUSSION

Follicular mucinosis Leonine facies

Axillary lymphadenopathy