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Folliculotropic Sézary syndrome: a new variant of cutaneous T‐cell lymphoma

SIR, The new WHO–EORTC (World Health Organization– European Organization for Research and Treatment of Cancer) classification system for cutaneous lymphomas incorporates a follicular variant of mycosis fungoides. Although it is considered a variant of classic mycosis fungoides, it is discussed separately because of its distinct clinicopathological features. These features include the marked folliculotropism of lymphocytes, clinically resulting in follicular papules, cysts or alopecia. This variant of mycosis fungoides has been reported to have a more aggressive clinical course than classic mycosis fungoides and to be frequently refractory to standard therapies. Prognostic studies have shown 5and 10-year survival rates of 64% and 14%, respectively, similar to tumour-stage mycosis fungoides. Sézary syndrome is the leukaemic phase of mycosis fungoides and also has a poor prognosis, with medial survival of 2–3 years. We report the clinical and histopathological features of two patients from our multidisciplinary cutaneous lymphoma clinic with a condition we refer to as folliculotropic Sézary syndrome.