European Journal of Dermatology


Inflammatory vitiligo-like macules that simulate hypopigmented mycosis fungoides Volume 13, issue 4, July 2003


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Department of Pathology, Hôpital Henri-Mondor, 51, avenue de Lattre de Tassigny, 94010 Créteil, France. Department of Dermatology, Hôpital Universitaire de Strasbourg, France. Department of Dermatology, Hôpital Henri-Mondor, Créteil, France

Two cases of an inflammatory vitiligo-like condition that simulated mycosis fungoides are reported. Both patients presented acquired hypopigmented macules sharply limited by an erythematous and papular border. The clinical aspect was suggestive of inflammatory vitiligo. Mycosis fungoides was suspected on skin specimens showing a dense band-like lymphocytic infiltrate with discrete nuclear atypias and marked exocytosis. This infiltrate was made of CD3 positive lymphocytes. CD8 positive lymphocytes were numerous in one case, few in the other. There was a loss of melanocytes in the lesional skin and absence of dominant T-cell clones in both cases. No repigmentation was observed after PUVA or local chemotherapy. The authors emphasized that erythematous and papular borders surrounding hypopigmented macules, CD8 positive lymphocytic infiltrate, absence of T-cell clonal rearrangement are helpful to rule out mycosis fungoides.