Bullous mycosis fungoides associated with an extensive ulcer and a severe leukemoid reaction

Abstract

This report presents a case of bullous mycosis fungoides associated with an extensive ulcer and a severe leukemoid reaction. The rash began as indurated erythema which was always followed by ulceration. The rashes initially responded to radiation therapy, but multiple recurrences appeared. Several bullae appeared on the trunk during the course of the illness, without any evidence of paraneoplastic pemphigus. Finally, the ulcer covered a large part of the trunk, and the patient died of sepsis with an extreme leukocyte count of 118,000/µL. A bone marrow analysis revealed a leukemoid reaction and an autopsy revealed pseudomembranous colitis.

A case of bullous Sézary syndrome

“…Bullous Sézary syndrome is even rarer with fewer than 10 cases reported. Bullous lesions may arise in existing lesions of CTCL or as the initial presentation, may be associated with patch, plaque, or tumoral lesions and display a predilection for the torso and extremities [2,[4][5][6][7][8][9][10][11]. Oral mucosal involvement was present in our patient and has been described in one other case of bullous Sézary syndrome [9].…”