No abstract

Mycosis fungoides is the most common type of primary cutaneous T-cell lymphoma. Several rare clinicopathological variants of mycosis fungoides have been described. Patients with these variants often also have classic mycosis fungoides at other sites of the body. Anetoderma is a cutaneous disorder in which multiple, oval lesions or atrophic plaques with wrinkled surface develop progressively due to loss of the dermal elastic tissue. Primary anetoderma occurs when there is no underlying associated disease and it arises on clinically normal skin, whereas secondary anetoderma appears in the same site as a previous specific skin lesion. There is a large list of heterogeneous dermatoses associated with secondary anetoderma. Two patients developed areas of secondary anetoderma on plaque stage lesions of mycosis fungoides. The lesions consisted of exophytic nodular lesions, with very soft consistency on palpation, scattered over the hyperpigmented plaques in one patient and violaceous indurated plaques with overlying epidermal atrophy and mild scale in the other. Histopathological study demonstrated that the cells involving the dermis were mainly T-helper lymphocytes, with few histiocytes and some multinucleate giant cells engulfing distorted elastic fibres. Elastic tissue stain demonstrated that elastic fibres were almost completely absent in the dermis of the anetodermic lesions. Anetodermic mycosis fungoides should be added to the list of clinicopathological variants of mycosis fungoides and mycosis fungoides should also be considered as a possible disease causing secondary anetoderma. Anetodermic mycosis fungoides shows clinical and histopathological features different from those of granulomatous slack skin.

Nevus sebaceous of Jadassohn, a cutaneous hamartoma, results from disordered development of epidermal, follicular, sebaceous and apocrine differentiation that typically appears as a yellow verrucous plaque on the scalp or face. We present a 36‐year‐old white male with a congenital, nodular lesion along the hairline of his forehead, which had been traumatized repeatedly during hair grooming. Clinically, it was a well‐demarcated, curvilinear, erythematous, non‐tender plaque with no umbilication, ulceration or discharge. The periphery had a circumferential tan‐yellow, raised, waxy serpiginous border. Microscopically, the specimen had epidermal papillomatous hyperplasia with dilated infundibula of irregular mature sebaceous lobules, and mid‐dermal apocrine gland lobules. Within the hamartoma, was a well‐circumscribed, multi‐lobulated dermal tumor with epidermal and follicular attachments, focal ductal differentiation and cystic changes. Two distinct cell types were present; in the center were large polyhedral cells with focal clear cytoplasm, and at the periphery were spindle‐shaped cells with basophilic cytoplasm. These findings were typical of nodular hidradenoma arising within a nevus sebaceous of Jadassohn, a rare event with only seven cases previously documented in the literature.