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May 1979

Mycosis Fungoides With Underlying Epidermoid Cysts

Author Affiliations

From the Division of Dermatology, Section of Dermal Pathology and Histochemistry, California College of Medicine, University of California, Irvine; and the Dermatology Section, Veterans Administration Hospital, Long Beach, Calif.

Arch Dermatol. 1979;115(5):622. doi:10.1001/archderm.1979.04010050052018

The cause of epidermoid cysts is disputed, and many mechanisms have been proposed.1,2 One generally accepted theory is mechanical obstruction of the follicle such as seen in milia, acne cysts, and rarely in association with neoplasms, particularly nevocellular nevi.3 Multiple epidermoid cysts of the face and scalp developed in a patient with mycosis fungoides. Histological examination exhibited extensive involvement of the hair follicles with dilation and cyst formation. Although this is an unusual phenomenon, its recognition is important since plaque-stage mycosis fungoides overlying epidermoid cysts may clinically mimic the tumor stage of the disease. The clinical picture may become even more deceptive since these cystic lesions would not be expected to respond to conventional therapy for mycosis fungoides.

Report of a Case  A 53-year-old man was admitted with the complaint of intense pruritus for two months. Twelve years before he had noted a patch of alopecia that slowly

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