Alopecia Mimicking Lichen Planopilaris in a Patient With Mycosis Fungoides

December 2024 in “ Skin Appendage Disorders ”

Daniel Asz Sigall, Marysol Macedo Perez, Rosa María Lacy‐Niebla, Carlos A. Barrera‐Ochoa, Roberto Arenas, Sonia Toussaint-Caire, Diana G. Santamaría-Domínguez, Diana Valeria Guerrero-Hernández, Irene Montserrat Rodriguez-Escamilla, Eduardo Corona‐Rodarte

alopecia lichen planopilaris mycosis fungoides alopecia areata folliculotropic mycosis fungoides scarring alopecia non-scarring alopecia trichoscopy histopathological evaluation atypical lymphocytic infiltrate follicular destruction NB-UVB isotretinoin intralesional corticosteroid injections hair loss UVB therapy Accutane corticosteroid shots

TLDR Accurate diagnosis and treatment improved symptoms in a patient with alopecia linked to mycosis fungoides.

This case report discusses a 58-year-old woman with a history of stage IB mycosis fungoides (MF) who developed alopecia mimicking lichen planopilaris (LPP) and alopecia areata (AA). The folliculotropic variant of MF (FMF) presented diagnostic challenges due to overlapping clinical features, necessitating histopathological evaluation for accurate diagnosis. The patient exhibited scarring and non-scarring alopecic patches, with trichoscopy revealing follicular involvement. Histological analysis confirmed FMF, characterized by atypical lymphocytic infiltrate and follicular destruction. Treatment with NB-UVB, isotretinoin, and intralesional corticosteroid injections led to symptomatic improvement. The case emphasizes the importance of histopathological evaluation and a multidisciplinary approach for effective management of FMF.

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