Syringotropic mycosis fungoides: Clinical and histologic features, response to treatment, and outcome in 19 patients Adele de Masson, MD, a,c,d Maxime Battistella, MD, b,d,e Marie-Dominique Vignon-Pennamen, MD, b Benedicte Cavelier-Balloy, MD, b Frederic Mouly, MD, a Michel Rybojad, MD, a Jean-David Bouaziz, MD, PhD, a,c,d Antoine Petit, MD, a Anne Saussine, MD, a Sophie Ronceray, MD, f Franc ¸ois Le Gall, MD, f Caroline Ram-Wolff, MD, a Philippe Assouly, MD, a Olivier Dereure, MD, PhD, h Pascal Joly, MD, PhD, i Alexiane Dallot, MD, j Alain Dupuy, MD, PhD, g Celeste Lebbe, MD, PhD, a,c,d Isabelle Moulonguet, MD, a Jacqueline Rivet, MD, PhD, b Anne Janin, MD, PhD, b,d,e and Martine Bagot, MD, PhD a,c,d Paris, Rennes, Montpellier, Rouen, and Aulnay, France Background: A rare variant of mycosis fungoides (MF), syringotropic MF (STMF) is characterized by a particular tropism of the lymphocytic infiltrate for the eccrine structures, and included in the follicular subtype of MF in the World Health OrganizationeEuropean Organization for Research and Treatment of Cancer classification of cutaneous lymphomas. Objective: We sought to determine the clinicopathologic features and disease course of patients with STMF. Methods: A retrospective study was conducted to identify patients with STMF from 1998 to 2013. Results: Nineteen patients were included: 15 men and 4 women, mean age 55 years (range, 24-86). Most had multiple lesions (n = 16, 84%) with associated alopecia (n = 12, 63%) and/or punctuated aspect (n = 12, 63%). Palms or soles were involved in 10 cases (53%). Folliculotropism was found in 13 cases (68%). After a median follow-up of 70 months (range, 2-140), 3 patients died, 1 from disease-related death. The 5-year overall and disease-specific survival were 100%. The disease-specific survival was significantly higher than in 54 patients with folliculotropic MF without syringotropism (5-year disease-specific survival, 74%; 95% confidence interval, 58%-94%, P = .02). Limitations: Retrospective setting is a limitation. Conclusions: In the spectrum of adnexotropic MF, STMF appears as a distinct entity from follicular MF, with peculiar clinical characteristics and natural history. ( J Am Acad Dermatol 2014;71:926-34.) Key words: cutaneous T-cell lymphoma; follicular; folliculotropism; mycosis fungoides; syringotropic; syringotropism. P rimary cutaneous lymphomas (PCL) are a heterogeneous group of malignancies of skin-homing lymphocytes. Mycosis fun- goides (MF) accounts for approximately 50% of all PCL. 1 The classic type of MF is characterized by a T-cell lymphocytic infiltrate in the papillary dermis, the presence of atypical lymphocytes with cerebri- form nuclei, and the evidence of epidermotropism From the Service de Dermatologie a and Laboratoire de Pathologie, b H^ opital Saint-Louis, Assistance Publique-H^ opitaux de Paris (AP-HP), Paris; Institut National de la Sante et de la Recherche Medicale (INSERM)-Unite Mixte de Recherche (UMR)-S976, Paris c ; Universite Paris VII Sorbonne Paris Cite d ; INSERM UMR-S928, Paris e ; Laboratoire de Pathologie f and Service de Dermatologie, g H^ opital Pontchaillou, Rennes; Service de Dermatologie, H^ opital Saint-Eloi, Montpellier h ; Service de Dermatologie, H^ opital Charles-Nicolle, Rouen i ; and Service de Dermatologie, H^ opital Robert-Ballanger, Aulnay. j Funding sources: None. Conflicts of interest: None declared. Accepted for publication June 17, 2014. Reprints not available from the authors. Correspondence to: Martine Bagot, MD, PhD, Service de Dermatologie, H^ opital Saint-Louis, 1 avenue Claude Vellefaux, 75010, Paris, France. E-mail: martine.bagot@sls.aphp.fr. Published online July 18, 2014. 0190-9622/$36.00 Ó 2014 by the American Academy of Dermatology, Inc. http://dx.doi.org/10.1016/j.jaad.2014.06.033 926