We report a juvenile case of mycosis fungoides with prominent follicular mucinosis (FM). The patient was a 9-year old boy who presented with a 2-month history of enlarging alopecic patch with fine scales on the scalp. Dermatologic examination revealed orange-tan slightly palpable plaques with follicular prominence on his trunk. The patient and his family were not aware of these asymptomatic truncal plaques. Histopathologic examination of both-scalp and trunk-lesions revealed folliculotropic lymphocytic infiltration with mucin. Immunohistochemical study showed that lymphocytic infiltration was CD4 dominant. Flow cytometry analyses of peripheral blood were normal. Any abnormal populations and Sézary cells were not observed on blood smear. Polymerase chain reaction testing showed monoclonality for the T-cell receptor4-[Latin Small Letter Rams Horn] gene. Our patient had the clinical and histopathological diagnosis of follicular mycosis fungoides-associated follicular mucinosis.
Objective: The aim of this study is to assess the impact of omalizumab on coagulation biomarkers and immunoglobulin E (IgE) levels in chronic idiopathic urticaria/chronic spontaneous urticaria (CIU/CSU) and bullous pemphigoid (BP) patients. Methods: Medical records of 31 CIU/CSU and 16 BP patients were reviewed according to the inclusion and exclusion criteria. Laboratory parameters for coagulation status and IgE levels at baseline and in the first 12-week period of omalizumab therapy were retrieved and analysed in the light of clinical response to the treatment. Results: At baseline, in CIU/CSU patients, IgE levels were significantly higher in responders [184.5 IU/mL (62-307 IU/mL)] than non-responders [25.6 IU/mL (10.8-30.2 IU/ mL)] (p=0.021). During the first 12 weeks of omalizumab therapy, a dramatic decrease in D-dimer levels was observed in serial measurements of CIU/CSU (p=0.001) and also BP patients (p=0.017). Total IgE levels were increased after omalizumab usage in all study groups (p=0.003) and elevation of IgE levels was found significant for CIU/CSU but not for BP (p<0.001, p=0.278, respectively). Conclusion: Baseline IgE levels may be used to predict which patients will gain benefit from omalizumab therapy in CIU/CSU group. During omalizumab therapy the plasma D-dimer levels show a dramatic decrease in the group of patients who responded of CIU/CSU and BP.
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