Verrucous pagetoid reticulosis: A case report

Erol Koc, Mustafa Tunca, Didem Dincer, Ercan Arca, Osman Kose, Murat Demiriz
2010 Balkan Military Medical Review   unpublished
Pagetoid reticulosis, also known as Woringer Kolopp disease, is an exceedingly rare variant of mycosis fungoides with good prognosis that primarily affects middle-aged males. We describe here a 22-year-old male patient with an erythematous, scaly, verrucous plaque on his left leg. Histopathological and immunohistochemical analyses confirmed the diagnosis. We successfully treated the patient with surgical excision and there was no recurrence in 2 years. To our knowledge this is the first case of
more » ... PR reported in the literature that presents with verrucous lesions. The morphologic spectrum of clinical presentation for mycosis fungoides is broad [1]. Pagetoid reticulosis (PR) is classified as one of the indolent forms of primary cutaneous T cell lym-phomas [2,3]. Despite the histologic resemblance to mycosis fungoides, these lesions are typically solitary and indolent [4,5]. Woringer and Kolopp first described a solitary cutaneous lesion showing epidermotropic lymphocytes on the forearm of a 13 years old patient [4]. We report here a case of PR presenting with verrucous aspect limited to the left leg of a 22-year-old male patient that persisted for up to 18 years without other cutaneous or systemic disease. To date, the lesions have remained localized and we treated our case successfully with surgical excision. Case Report Eighteen years ago, the patient developed a plaque on the left leg, measuring approximately 4 cm. New lesions developed over the left leg in the following years. These lesions failed to respond to topical steroids and his condition progressed until the lesions became increasingly hyperkeratotic and verrucous. Family and personal history were not significant. Complete blood count, urinalysis, short routine chemistry, IgE, chest X-ray and HRCT (high resolution computerized tomography) were all normal. On dermatological examination, there were several round to oval, verrucous, hyperkeratotic, yel-lowish, scaly plaques, 3 to 4cm in diameter, localized on the left leg (Figure 1).