Ichthyosiform mycosis fungoides with alopecia and atypical membranous nephropathy
Date
2011-10-06
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Medknow Publications on behalf of The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL)
Abstract
Description
We describe here a rare case of variant of mycosis fungoides (MF):
ichthyosiform MF with alopecia and atypical membranous nephropathy. The
diagnosis was made based on the following findings: generalized
ichthyosis-like eruption, alopecia, enlarged superficial lymph nodes,
proteinuria, and hematuria, the histological features of the skin
biopsy from both ichthyotic and alopecic lesions with
immunohistochemical staining, and the renal biopsy examination with
immunofluorescence. The histological examination of ichthyotic and
alopecic lesions displayed a predominant infiltration of atypical
lymphocytes in the upper dermis with the characteristics of
epidermotropism and folliculotropism. Immunohistochemical studies
demonstrated that most infiltrated atypical lymphocytes were CD3, CD4,
and CD45RO positive, whereas negative for CD5, CD7, CD20, CD30, and
CD56. A renal biopsy examination revealed atypical membranous
nephropathy with deposition of immunoglobulin G (IgG), IgM, IgA, C1q,
and C3. In this case atypical membranous nephropathy was involved,
which is very uncommon and has never been presented in the literature
to date. Although ichthyosiform MF usually features a relatively
favorable course, diffuse alopecia and the renal involvement in this
case might indicate aggressive disease and poor prognosis.
Keywords
alopecia, nephropathy, Ichthyosiform mycosis fungoides
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