Follicular mucinosis (FM) is an epithelial reaction pattern characterized by follicular mucin accumulation. It has been described in association with various inflammatory and neoplastic cutaneous disorders. FM is generally divided into a primary benign idiopathic form and a secondary form usually occurring in association with cutaneous lymphomas (especially mycosis fungoides), among other entities. Distinction between the two forms can be challenging as they share many overlapping features and the lack of a single diagnostic tool to differentiate between the two. Making the distinction may require evaluating and correlating the clinical, histologic, immunohistochemical, and molecular studies together. Long‐term clinical follow‐up also remains very important. In this review, we describe the different entities associated with FM, its pathogenesis, and possible therapeutic options.
Reply to ''Immune checkpoint inhibitor-related dermatologic adverse events''To the Editor: We recently read with great interest the article titled ''Immune checkpoint inhibitor-related dermatologic adverse events'' by Geisler et al. 1 In this recent continuing medical education activity, the authors described in detail the current data on cutaneous immune-related adverse events that have been described in patients receiving immune checkpoint inhibitors (CPIs).Of particular interest are the various subtypes of cutaneous eruptions that may appear, including macular/papular rashes and psoriasiform, and lichenoid eruptions. Indeed, treatment with CPIs can result in a spectrum of adverse cutaneous events. Here, we would like to complement the authors by drawing attention to their reports on unique follicular involvement in these cutaneous eruptions. Follicular involvement has been described both clinically and histologically in patients receiving CPIs, 2-4 especially as a peculiar form of a lichenoid eruption pattern. 2,3 Clinically, CPIs have been reported to cause immune-related cutaneous adverse events involving the hair follicle, commonly described in the form of folliculitis with lichenoid features (Fig 1).
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