Alopecia mucinosa. Additional data in 1983

Follicular Mucinosis

“…After the report by Pinkus, several publications proposed the existence of 2 main types of FM. [3][4][5][6][7][8][9][10][11][12][13][37][38][39][40][41][42][43] The first type occurs in young patients in the absence of concomitant cutaneous or extracutaneous disorders and shows localized lesions with a tendency to resolve within a few years (idiopathic FM). The second type occurs in elderly patients and is associated with mycosis fungoides or Sézary syndrome.…”

“…Subsequent reports suggested that at least 2 distinct entities were encompassed under this diagnosis: one occurring in children and young adults without association with other cutaneous or extracutaneous diseases ("idiopathic" FM), the other occurring in elderly patients and associated with mycosis fungoides or Sé zary syndrome ("lymphoma-associated" FM). [3][4][5][6][7][8][9][10][11][12][13] In addition, progression of idiopathic FM into cuta-neous T-cell lymphoma (CTCL) has been well documented in several cases. [14][15][16][17][18] In this study, we reviewed data from a large group of patients with idiopathic and lymphoma-associated FM with respect to clinicopathologic presentation and molecular features.…”

Response to the Letter

“… Not all cases of mycosis fungoides progressed to more advanced plaque or tumorous stage. Lesions of the classical mycosis fungoides and other forms of mycosis fungoides may remain as patches and thin plaques for life. Approximately 12–32% of alopecia mucinosa/follicular mucinosis cases have been associated with or transformed into clinically and pathologically overt lymphoma 3,4 Lymphocytic epidermotropism and nuclear atypia in early patch and thin plaque lesions of mycosis fungoides can be very subtle.…”

“…Approximately 12–32% of alopecia mucinosa/follicular mucinosis cases have been associated with or transformed into clinically and pathologically overt lymphoma 3,4 …”

Alopecia mucinosa or follicular mucinosis – the problem is terminology!

“…Even tumors marked clinically by necrosis and histopathologically by ‘follicular mucinosis’ were diagnosed as alopecia mucinosa, not mycosis fungoides 6 . At long last, in 1983, when in several patients with ‘alopecia mucinosa’ lesions had become widespread and tumors of mycosis fungoides had become manifest, Pinkus, himself, advised that ‘alopecia mucinosa’ should be ‘referred to as a potential first stage of mycosis fungoides’ 7 …”