Background: Follicular mucinosis (FM), defined by mucin accumulation within follicular epithelium, may occur in mycosis fungoides (MF). FM without MF is occasionally reported in systemic hematologic malignancies, and may be diagnostically challenging. Objective: To describe clinicopathological characteristics of FM in patients with hematologic malignancies other than MF. Methods: Clinical data and histopathology were analyzed in patients with FM and hematologic malignancies diagnosed between 1994 and 2017. Results-Eighteen patients with FM and systemic hematologic malignancies without cutaneous T-cell lymphoma (CTCL) were identified, nine of them were post hematopoietic stem cell transplantation (HSCT). No non-CTCL associated FM cases (n=46, 37 biopsies) developed CTCL during mean follow-up of 4.3 years. Of CTCL associated with FM (n=44, 31 biopsies) MF was the most common subtype (n=38), although other CTCLs were identified. FM in patients with non-CTCL hematologic malignancies differed clinically from MF-associated FM, presenting most frequently with erythematous papules (P < .0001), without plaques (P <.0001), without alopecia (P = .001), and without histopathologically identified epidermal exocytosis (P = .013). Limitations: A retrospective study in a single cancer center.

Introduction: Frailty is a state of vulnerability characterized by multisystemic physiological decline. The Pictorial Fit Frail Scale (PFFS) is a practical, image-based assessment that may facilitate the assessment of frailty in individuals with inadequate health literacy (HL). Objective: Determine the concurrent validity and feasibility of the PFFS in older Veterans with different levels of HL and cognition. Methods: Cross-sectional study in a geriatric clinic at a Veteran Health Administration (VHA) medical center. Veterans ≥65 years old completed a HL evaluation, PFFS, FRAIL scale and cognitive screening. We assessed the associations between PFFS, FRAIL scale, and VA-Frailty Index (VA-FI), and compared PFFS and FRAIL scale accuracy with a Receiver Operating Characteristic curve, Area Under the Curve (AUC) analysis, using the VA-FI as reference. Results: Eighty-three Veterans, mean age 76.20 ( SD = 6.02) years, 65.1% Caucasian, 69.9% had inadequate HL, 57.8% were frail and 20.5% had cognitive impairment. All participants completed the 43 PFFS items. There were positive correlations between PFFS and VA-FI, r = .55 (95% CI: 0.365–0.735, p < .001), and FRAIL scale, r = .673 (95% CI: 0.509–0.836, p < .001). Compared to the VA-FI, the PFFS (AUC = 0.737; 95% CI: 0.629–0.844) and FRAIL scale (AUC = 0.724;95% CI: 0.615–0.824; p < .001) showed satisfactory diagnostic accuracy. Conclusions: The PFFS is valid and feasible in evaluating frailty in older Veterans with different levels of HL and cognition.

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