Inflammatory vitiligo versus hypopigmented mycosis fungoides in a 46 year - old iranian woman (histopathological and immunohistochemical study): a case report and review of the literature

The diagnosis fundament of vitiligo is focusing clinical manifestations followed by biopsy that is helpful for discriminating disorder from other clinical conditions characterized by hypo pigmentation. The rare inflammatory variant of vitiligo may be difficult to distinguish from hypo-pigmented mycosis fungoides (MF) on clinical, histological and even immunohistochemical grounds. Both diseases show dermal lymphocytic infiltration, exocytosis, interface dermatitis and mild spongiosis (particularly when biopsies are taken from the periphery of early vitiliginous lesions or from lesions with an inflammatory borders). Also both disorders show a predominance of CD8+ T cells in tissue samples. We present a case with clinical findings of several depigmented patches on the forehead, eyelids, and dorsal hands, the near-total loss of melanocytes evident with Melan-A staining, and PCR findings demonstrating a lack of monoclonality, although according to combination of clinical, histological, immunohistochemical and molecular study, inflammatory vitiligo was favored but hypo pigmented MF could not ruled out definitely.