Vesiculobullous Mycosis Fungoides

Bullous mycosis fungoides (MF) is a rare clinical variant that shows generalized blisters and bullous lesions, sometimes with a predilection for palms and soles. It may resemble bullous pemphigoid, pemphigus vulgaris, or pemphigus foliaceus but behaves like classical MF. Bullous pemphigoid may sometimes arise in patients with MF after PUVA, Ultravioled B therapy or other topical treatments.

Microscopically, the blisters are most commonly subepidermal but may be subcorneal or intraepidermal. Immunofluorescence is negative. Special stains (grams, PAS) should be done to rule out infection.