Localized mycosis fungoides not manifesting as Woringer-Kolopp disease

Abstract

A 68-year-old man had a solitary, eczematiform lesion of two years' duration on the digital dorsal surface of his right foot. Despite its innocuous appearance, the lesion showed histologic characteristics of advanced, plaque-type mycosis fungoides. The patient's clinically benign yet histologically malignant disease manifestation is discussed. The distinction between localized mycosis fungoides and Woringer-Kolopp disease is also reviewed.

Unilesional Follicular Mycosis fungoides

“…Woringer-Kolopp disease, also known as localized pagetoid reticulosis, is characterized by a single verrucous plaque with polycyclic borders and central clearing and is now regarded as a benign localized variant of MF with prominent epidermotropism [15]. More recently, other cases of unilesional MF, clinically and histologically different from Woringer-Kolopp disease, have been reported [1, 2, 3, 4, 5]. They show eczematoid, psoriasiform or poikilodermatous patches or plaques consistent with classic MF and are histopathologically identical to MF.…”

“…Within the clinical spectrum of the disease, unilesional MF [1, 2, 3, 4, 5]seems to be very rare, and follicular MF (FMF) [6, 7, 8, 9, 10]is also considered an unusual clinical and histological variant of MF, characterized by selective involvement of hair follicles by lymphoma cells.…”

Follicular Mucinosis

“…In this context, it should be noted that several variants of mycosis fungoides with prolonged, nonaggressive clinical course have been described, such as unilesional (solitary) mycosis fungoides, localized pagetoid reticulosis (Woringer-Kolopp disease), and parapsoriasis en plaques. 54,[56][57][58] Moreover, it has also been recognized that most patients with mycosis fungoides experience a chronic disease with prolonged survival. 19,54,69,70 Our results, and findings from review of the literature, suggest that idiopathic FM may represent a variant of mycosis fungoides with localized disease and excellent prognosis, conceptually similar to the localized variant of pagetoid reticulosis (Woringer-Kolopp disease).…”

Unilesional Mycosis fungoides

“…The few reports appearing in the literature since 1981 [2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13], usually using the term ‘unilesional MF’ [3, 4, 5, 6, 7, 8, 9, 12], indicate that this variant of MF is rare, presenting as an isolated patch or plaque, generally indistinguishable clinically and histopathologically from typical MF. It follows a benign course for long periods without any treatment, and the initial reports stressed that there had been no case of disease recurrence after curative-intent treatment after variable follow-up periods [1, 2, 3, 4, 5, 6, 7].…”

“…It follows a benign course for long periods without any treatment, and the initial reports stressed that there had been no case of disease recurrence after curative-intent treatment after variable follow-up periods [1, 2, 3, 4, 5, 6, 7]. Very recent publications, however, indicate that there may be local recurrence [8, 9, 11, 13]and even relapse at distant sites after therapy such as radiotherapy [8].…”