Microscopic examination of the biopsy specimen revealed a dense lymphocytic infiltrate of the superficial dermis, with marked involvement of the perifollicular dermis and follicular epithelium ("folliculotropism"). No epidermotropism was present. The infiltrate was monomorphous and composed of atypical UCHL-1 (CD-45RO)– and CD4-positive lymphocytes; some nuclei were hyperchromatic and cerebriform. Eosinophils and plasma cells were absent. There were no cystic spaces or mucin in the outer root sheath, and an Alcian blue stain was negative for mucin within the follicles. A second biopsy specimen was obtained for ultrastructural study. Large lymphocytes with convoluted nuclei were present within the follicular epithelium.
Asymptomatic Follicular Papules With Alopecia on the Lower Part of the Leg. Arch Dermatol. 2001;137(5):657-662. doi: