Aim: Unilesional mycosis fungoides (UMF) was firstly described in 1981 as solitary lesion with clinical and histological features of MF. Although over 100 cases have been reported in the literature, there is a lack of clear-cut criteria characterising UMF. Only 10 cases featured by follicolotropism of the neoplastic T-cells have been reported: the so-called unilesional folliculotropic MF (UFMF). This paper questions whether or not UFMF should be considered as a true rarity in MF clinico-pathological spectrum.
Methods: We retrieved 28 folliculotropic MF cases in the database of the Dermatological Divisions of Bologna (12 patients) and Florence University (16 patients). Four of them were UFMF patients (2 males and 2 females, mean age 45 years; median age: 39 years).
Results: All patients achieved after therapy disease complete remission. Notably, only one patient was treated with radiotherapy, that seems the most recommended strategy in UMF. For the remaining patients, we choose different managements in order to achieve both clinical efficacy and the best aesthetical outcome.
Conclusion: No definitive conclusions can be drawn whether or not UFMF has the same indolent clinical course of UMF. Recently, Kempf et al. reported 2 UFMF patients with progression to tumour stage and large-cell transformation, respectively. UFMF in our database is 14.3% of the 28 FMF cases. Our data suggest that UFMF can be regarded as a true rarity in MF clinico-pathological spectrum.