The clinical and epidemiological profile of patients with hypopigmented MF found in our sample is in agreement with what is described in the literature, with the exception of the age at diagnosis, higher than expected. Diagnostic delay time, despite long, is also consistent with the medical literature; however, in this sample, we had two cases of disease progression, with death of one patient, despite the treatment, which is extremely important since hypopigmented MF is usually associated with good prognosis.

BackgroundMycosis fungoides is the most common form of primary cutaneous lymphoma, with an indolent, slowly progressive course and 88% five-year survival rate. The diagnosis is challenging, especially in the early stages, and usually relies on a good clinical-histopathological correlation.ObjectiveThe aim was to establish the clinical and epidemiological profile of patients with early-stage mycosis fungoides.MethodsThis was a retrospective cross-sectional observational study with an exploratory analysis. Outcome variables were disease progression and mycosis fungoides-related death.ResultsOne hundred and two patients were included. The majority were white males, with a mean age of 55.6 years. Mean time from onset of lesions to diagnosis was 51.08 months. The majority of patients were classified as IB stage according to TNMB. Mean follow-up time was 7.85 years. Disease progression was seen in 29.4% of the patients. Death related to the disease occurred in 7.9% of patients. Plaque lesions, involvement of more than 10% of the body surface, altered lactate dehydrogenase and beta-2-microglobulin, and stage IB were significantly associated with disease progression, and altered lactate dehydrogenase and beta-2-microglobulin also correlated with higher frequency of deaths.Study limitationsSmall sample and retrospective design.ConclusionsThe clinical and epidemiological profile of patients with early-stage mycosis fungoides in our sample corroborates reports in the literature. Diagnostic delay in our series is also consistent with previous findings, but the rate of disease progression, despite treatment, was higher than reported in the literature.

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Flagellate dermatitis shows very characteristic lesions: linear erythema or hyperpigmentation in various areas of the skin. It is a side effect of bleomycin, an immunosupressive drug used for several types of cancers. All physicians must be aware of this disease so they can make a rapid diagnosis and interrupt the causative agent. Our patient presented during chemotherapy for a Hodgkin's lymphoma pruritic, erythematous lesions on the lower limbs and the back diagnosed as flagellate dermatitis due to bleomycin.

A 39‐year‐old woman was referred with a 1‐year history of a 4‐cm mass of the left axilla, compatible with a lymph node. Itchy red papules that evolved to crusty lesions and subsequently showed varioliform atrophic scarring appeared over the face, extensor surface of the arms, back, thighs, and scalp (Figs 1 and 2). Her history included weight loss of 8 kg, but no other associated symptoms or contact with tuberculosis patients. The blood count showed a normochromic–normocytic anemia with an erythrocyte sedimentation rate (ESR) slightly elevated at 28 mm in the first hour (normal, < 20 mm). Tuberculin skin test was positive (13 mm with necrotic reaction) and anti‐human immunodeficiency virus serology was negative. Four lesional skin biopsies and one lymph node biopsy were performed and sent for histopathology and culture. The skin biopsy showed small‐vessel lumen occlusion by tiny thrombi, endothelial hyperplasia, and intense perivascular inflammatory reaction throughout the dermis, together with partial degeneration of collagen, compatible with tuberculid. Lymph node biopsy showed chronic, necrotizing, granulomatous lymphadenitis, consistent with a diagnosis of lymph node tuberculosis. Mycobacteria were absent on Ziehl–Neelsen staining and culture in all specimens. 1 Varioliform atrophic scarring over the extensor surface of the arms, typical of papulonecrotic tuberculid (PNT) 2 Varioliform atrophic scarring over the back, typical of papulonecrotic tuberculid (PNT)  On the basis of the clinical features, positive tuberculin skin test, and histopathologic findings, a diagnosis of papulonecrotic tuberculid associated with tuberculous lymphadenitis was made. A triple therapeutic regimen with rifampicin, isoniazid, and pyrazinamide was started and the patient evolved with progressive clinical improvement. At the end of treatment at 6 months, there was clinical remission and improvement of anemia and ESR. Four months later, however, there was a clinical relapse of the lesions on the scalp, ultimately resulting in cicatricial alopecia with varioliform atrophic scarring (Figs 3 and 4). A biopsy of these new lesions was performed and showed focal necrosis (V‐shaped) in the epidermis and dermis with follicular involvement and thrombotic occlusion of vessels, confirming the diagnosis of tuberculid. The patient was retreated with rifampicin, isoniazid, pyrazinamide, and ethambutol for 9 months. A new investigation of another internal focus of tuberculosis was negative. 3 Cicatricial alopecia with varioliform atrophic scarring appearing after 6 months of treatment for tuberculosis 4 Cicatricial alopecia with varioliform atrophic scarring appearing after 6 months of treatment for tuberculosis  In the last 2 years, the patient has had several recurring crops of lesions on the scalp. Further biopsies were taken, with histopathology showing nonspecific inflammatory changes. Cultures for Mycobacterium spp. were negative (five media: Lowenstein–Jensen, Lowenstein–Jensen supplemented with ferric ammonium citrate or pyruv...