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Papular mycosis fungoides (MF) is an uncommon clinical variant of early MF without prognostic implications that follows an indolent course over years. It is characterized by the presence of multiple, small, pruritic, flat-topped, erythematous papules, often presenting as a nonspecific papular eruption which makes early diagnosis difficult. We describe two cases of elderly patients with papular MF, a probably underdiagnosed entity, which causes a significant deterioration in quality of life of patients who may benefit from specific treatments such as phototherapy.

A 97-year-old man with a history of type II diabetes mellitus was treated with oral antidiabetic agents. He went to the emergency department after the appearance of blister-like itchy lesions on the abdomen and extremities since 2 months. The examination revealed eczematous lesions on the back, abdomen and extremities along with tense blisters on an erythematous base and serous content (figure 1A). In the blood test carried out, 285?mg/dL glucose and 7.1% eosinophilia stood out, with no associated leucocytosis or other relevant findings. Positive glycosuria (+++) was observed in urinalysis without other alterations. A skin biopsy was performed for histological and immunofluorescence studies that confirmed the diagnosis of bullous pemphigoid (figure 1B–D). Given the poor control of autoimmune blistering disease, possible triggers were looked for and linagliptin intake could be associated with the appearance of skin lesions 1?month earlier. ...