Parakeratosis variegata: A possible role of environmental hazards?

We report 2 cases of parakeratosis variegata (PV) evolving from lesions beg inning with characteristics of ashy dermatosis. Both patients presented wit h a reticulated, poikilodermatous and hyperpigmented eruption with bizarre coalescent lichenoid papules. Histology showed lichenoid epidermotropic inf iltrates, more pronounced in case No. 1, consistent with early malignancy. The course was chronic: after more than 10 years, systemic symptoms were no t present. In patient No. 1, a monoclonal T-cell population was detected 12 years after the onset of the disease. Both patients had close contact with fertilizers and insecticides. In patient No. 2, the lesions spontaneously regressed within 3 years after cessation of exposure. PV may be a prelympho matous stage of mycosis fungoides or some closely related cutaneous T-cell lymphoma and does not always evolve into overt malignancy. Gene rearrangeme nt detection techniques may be helpful in predicting the course of the dise ase. Copyright (C) 2000 S. Karger AG, Basel.