Mucin deposits in hair follicles may represent a form of localised cutaneous T-cell lymphoma.
This condition – idiopathic follicular mucinosis – is analogous to localised pagetoid reticulosis (Woringer-Kolopp disease), small-plaque parapsoriasis and so-called solitary mycosis fungoides, according to dermatologists at the University of Graz, Austria.
They noted that since 1957, patients had been described with localised alopecia characterised histopathologically by follicular mucinosis. At least two distinct diagnostic entities had been proposed.
One of these was idiopathic follicular mucinosis in children and young adults not associated with other diseases. The other, lymphoma-associated follicular mucinosis, occurred in elderly patients and was associated with mycosis fungoides or Sézary syndrome.
To determine whether idiopathic and lymphoma-associated follicular mucinosis were distinct or related conditions, the dermatologists looked at 44 patients with follicular mucinosis.
One group comprised 16 patients (mean age 37.5 years) with no associated mycosis fungoides or Sézary syndrome. A second group comprised 28 patients (mean age 52.2 years) who had clinicopathological evidence of cutaneous T-cell lymphoma.