Biomedical subjects
Publications and source records attributed to Joy M Twersky.
BACKGROUND: Mycosis fungoides has numerous clinical presentations. METHODS: We present two cases in which mycosis fungoides clinically mimicked reticular erythematous mucinosis. RESULTS: Both patients had extracutaneous involvement. One had a fatal outcome. CONCLUSIONS: We suggest that full systemic evaluation be performed at the time of presentation of patients with this variant of mycosis fungoides.
BACKGROUND: Tinea capitis is a common scalp dermatosis with several clinical patterns. Only two patients with a presentation of tinea capitis mimicking dissecting cellulitis have been described in the English literature. OBSERVATION: We report a patient with tinea capitis mimicking dissecting cellulitis who did not respond to griseofulvin therapy at 16 mg/kg/day but eventually cleared after a protracted course of higher dose griseofulvin. CONCLUSION: recognition of a dissecting cellulitis-like pattern of tinea capitis will increase clinical suspicion and avoid inappropriate management of a recalcitrant "dissecting cellulitis" in favor of prompt antifungal therapy of appropriate dosage and duration for patients with this unusual variant of tinea capitis.
Exclusion of cutaneous T-cell lymphoma (CTCL) by another dermatosis has not been reported. The mechanism for the epidermotropism of helper T lymphocytes in this indolent malignancy is not known. Although there is evidence that Langerhans cells (LC) play a role in the epidermotropism of lymphocytes in CTCL, clinical or in vivo support is lacking. We describe a patient with CTCL who developed herpes zoster involving the left T8 dermatome. When his CTCL became widespread after the herpes zoster healed, the previously affected areas of herpes zoster and their periphery were clinically free of lymphoma. Immunohistochemical analysis of a clinically uninvolved patch revealed absence of CD1a(+) cells in the epidermis, consistent with loss of LC in the areas spared by CTCL. There was no loss of LC in areas affected by CTCL. This is an unusual inhibition of CTCL by a prior viral infection. The loss of LC in the clinically spared skin suggests a role for LC in the epidermotropism of lymphocytes in CTCL.
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