Clinical Pathological Correlations > Mycosis Fungoides > Diagnosis and Discussion
The patient is a 31 year old man with a history psoriasiform dermatitis and chronic folliculitis.
He has been treated with directed UV irradiation and Targretin. He now presents with progressive skin lesions on his left eyebrow, left cheek, ear and postauricular space.
The diagnosis is Mycosis Fungoides with marked Folliculotropism (ref:1,4). Immunohistochemistry showed CD2, CD3 and CD5 positivity. There was reduced CD7 expression and scattered CD8, CD20 and CD56 positive cells. A review of recent literature shows that a GeneScan analysis of γ-chain T-cell receptor rearrangement was more effective than the traditional gel electrophoresis analysis 84% vs. 67% in MF patients (ref:2,3). There is also a high prevalence of oligoclonal TCRγ gene rearrangement with temporary dominance of transient clones (ref:5). Multiple biopsies may be required to identify the pathologic clone.
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