不伴有毛囊黏蛋白沉积的向毛囊性蕈样肉芽肿1例国内首报

First report of folliculotropic mycosis fungoides without association of follicular mucinosis

报告1例不伴有毛囊黏蛋白沉积的向毛囊性蕈样肉芽肿。患者女,53岁。全身泛发红色毛囊性丘疹伴瘙痒1年。皮肤科检查见躯干、四肢泛发针头大红色毛囊性丘疹,密集分布,互不融合,外观酷似突起的鸡皮疙瘩,触之粗糙。皮损不累及头面部、手掌和足部。皮损组织病理检查:毛囊周围可见以淋巴细胞为主的细胞浸润,部分细胞侵入毛囊上皮和表皮,细胞深染,核周有空晕,异形不明显。免疫组化染色结果证实浸润的淋巴细胞主要是T淋巴细胞。皮损T细胞受体(TCR)基因重排阳性。诊断:不伴有毛囊黏蛋白沉积的向毛囊性蕈样肉芽肿。

A case of folliculotropic mycosis fungoides without association of follicular mucinosis is reported. A 53-year-old woman presented with disseminated red follicular papules with itching for 1 year. These pinhead-sized papules densely distributed over the trunk and four limbs no confluence, which looked like exaggerated goose-flesh and felt like a nutmeg grater. The head, palm and feet were not affected. The main pathological changes showed peri folliclar infiltration of lymphocytes, with hyperchromasia, peri-nuclear halo and without obvious atypia. Some lymphocytes entered into the follicular epithe- lia and epidermis. Immunohistochemistry confirmed that the majority of lymphocytes infiltrated were T lymphocytes. Further detection showed that the skin lesion contained clonal TCR （T-cell receptor） rearrangement. Folliculotropic mycosis fungoides without association of follicular mucinosis was diagnosed.