Psoralen and ultraviolet -A therapy in folliculotropic mycosis fungoides: Long-term outcome in a young female patient – A 4-year follow-up

Folliculotropic mycosis fungoides (FMF) is a rare variant of cutaneous T-cell lymphoma characterized by folliculotropic lymphocytic infiltration, and its diagnosis is challenging due to the diverse clinical manifestations, especially in patients with atypical presentations and skin color. We report the case of a 28-year-old female with skin of color who presented with a hypopigmented, atrophic facial plaque, which was initially misdiagnosed and inadequately treated. Histopathology and immunohistochemistry confirmed the diagnosis of FMF, classified as stage 1A. Following the Dutch cutaneous lymphoma group guidelines, a treatment plan of 10 sessions of psoralen and ultraviolet-A therapy was implemented, leading to significant clinical and histopathological improvement. The patient has remained in remission for 4 years of follow-up without the need for further interventions. This case underscores the diagnostic complexities and therapeutic challenges associated with FMF, particularly in younger patients and underrepresented populations, and emphasizes the need for inclusive research to develop personalized treatment guidelines. It highlights the importance of early diagnosis, personalized therapy, and diversity in clinical research to optimize outcomes for patients with FMF.