Pagetoid reticulosis (Woringer–Kolopp disease) mimicking eczema: a case report with immunophenotypic analysis and literature review

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Pagetoid reticulosis (PR), or Woringer–Kolopp disease, is a rare subtype of cutaneous T-cell lymphoma often misdiagnosed due to its non-specific presentation.
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A 53-year-old female with a 5-year history of pruritic erythema on the ankle was initially mismanaged as chronic eczema before a definitive diagnosis of localized PR.
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Histopathological analysis revealed atypical lymphocytes with a pagetoid distribution and Pautrier-like microabscesses, confirming the diagnosis of localized PR.
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Immunohistochemistry showed a T-cell lineage with significant loss of CD4, CD7, and predominantly absent CD2/CD8 expression in the atypical lymphocytes.
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The patient was treated with topical clobetasol propionate, leading to substantial clinical resolution, highlighting the importance of early biopsy and immunophenotypic evaluation.

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