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  • Title: Invisible mycosis fungoides: A diagnostic challenge.
    Author: Pujol RM, Gallardo F, Llistosella E, Blanco A, Bernadó L, Bordes R, Nomdedeu JF, Servitje O.
    Journal: J Am Acad Dermatol; 2000 Feb; 42(2 Pt 2):324-8. PubMed ID: 10640924.
    Abstract:
    We describe a 76-year-old woman who presented persistent generalized pruritus as the only cutaneous manifestation of a cutaneous T-cell lymphoma (mycosis fungoides). No cutaneous lesions were observed throughout the patient's course. Skin biopsies obtained from normal-looking pruritic skin revealed a discrete perivascular lymphocytic infiltrate in the upper dermis and focal intraepidermal clusters of atypical lymphoid cells (Pautrier's microabscesses). PCR analysis of TCR-gamma gene disclosed a monoclonal T-cell rearrangement. Sequencing of the PCR monoclonal product identified the J(8)V(2)C(2) TCR gene rearrangement. This observation illustrates the existence of a peculiar and exceedingly rare form of mycosis fungoides characterized only by persistent pruritus unresponsive to several therapeutic approaches. The diagnostic difficulties of this rare variant are stressed.
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