Authors: Dr Sara M Alghmadi , Dr Azza S Alzahrani , Dr Adel A Alghmadi , Dr Asail S Alghmadi , Dr Lama S Alahmadi , Dr Mohammed A Alahmadi

Abstract

Background: Granulomatous slack skin syndrome (GSSS) is a rare variant of mycosis fungoides (MF), a form of cutaneous T-cell lymphoma, characterized by lax, pendulous skin folds predominantly affecting flexural areas. Hypopigmented mycosis fungoides (HMF) is another uncommon variant that presents with hypopigmented macules and patches, often in younger individuals with darker skin tones. The simultaneous occurrence of GSSS and HMF in a single patient is exceptionally rare, with only one prior case reported in the literature.

Case Presentation: We report the case of a 31-year-old woman presenting with clinical features consistent with both GSSS and HMF. The diagnosis was established based on clinical examination, histopathological findings, immunohistochemical analysis, and molecular studies.

Results and Conclusion: Clinical findings demonstrated overlapping features of GSSS and HMF, supported by histopathology and immunophenotyping consistent with MF despite negative T-cell receptor gene rearrangement. This case highlights the rare coexistence of these variants and underscores the importance of clinicopathological correlation and multiple biopsies in atypical presentations.

Keywords: Granulomatous slack skin syndrome, Hypopigmented mycosis fungoides, Cutaneous T-cell lymphoma, Mycosis fungoides variants.