Follicular mucinosis associated with scarring alopecia, oligoclonal T- cell receptor Vβ expansion, and Staphylococcus aureus: When does follicular mucinosis become mycosis fungoides?

A diagnosis of alopecia mucinosa, occurring as a single scalp lesion, was made in a 40-year-old white woman who had a history of trauma. Follicular mucinosis, Staphylococcus aureus, and oligoclonal expansion of the T-cell receptor Vβ chain genes 6 and 7 were present in the skin. Epidermotropic T- cell skin diseases with oligoclonal T-cell proliferations may be the result of HLA- and cytokine-determined reaction patterns to persistent antigens.