Indian Journal of Dermatology
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CASE REPORT
Year : 2009  |  Volume : 54  |  Issue : 5  |  Page : 32-36

Poikilodermatous parapsoriasis - two cases with review of literature


Nilratan Sircar Medical, College and Hospital, Kolkata, India

Correspondence Address:
Sudip Das
P103 Bosenagore Madhyamgram 24 Parganas (N), Kolkata - 700 129
India
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Source of Support: None, Conflict of Interest: None


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Poikilodermic parapsoriasis is a rare varaint of poikiloderma where the chances of going into mycoses fungoides exists.But not all cases do go to mycoses. In the early stage of poikiloderma atrophicans vasculare, without respect to its course, shows moderate thinning of stratum malpigji, effacement of rete ridges, hydropic degeneration of basal cells. In the upper dermis-there is band like infiltrate which in places invades the epidermis. The infiltrate consists of a few histiocytes-so called initial 'lichenoid pattern'. In addition there is abundance of melanophages with pigment incontinence. In late stages there is thinning of is with hydropic degeneration of basal cells. In MF inflammatory infiltrate increases rather than decreases in time. Large hyperchromatic nuclei, so called 'mycoses cells' are likely to be present in this variant and often there is moderate to marked epidermotropism. It may result in Pautrier microabscess. formation.The diagnosis of Mycoses Fungoides is supported by presence of an aberrant phenotype, for example T cell lacking one or more pan T cell antigens. Most commonly absent antigen is CD-7 followed by CD-2, CD-3 and CD-5 3 . Making a differential diagnosis between early MF and parapsoriasis is often difficult at clinical and histological level. We report two cases of poikilodermic parapsoriasis, both showing some degree of epidermotropism ,but one had panT cell marker CD 3, CD5, CD7 present and other absent.The lady with Pan T cell markers did not progress to frank mycoses fungoides while the patient with absent markers progressed rapidly and finally succumbed.


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