We are presenting a case report of patient with mycosis fungoides. The classical clinical picture usually evolves through 3 stages. Serpiginous mycosis fungoides in a 21yearold man jaad. We present a case of a 69yearold man with an atypical case of retiform mf. Mycosis fungoides mf is the most common group of cutaneous tcell lymphomas. Hypopigmented mycosis fungoides hmf is an extremely rare variant, but relatively common in childhood. Mycosis fungoides in critically ill cancer patients. The other reason is that mycosis fungoides is a great imitator and clinical diagnosis. Mycosis fungoides is also known as alibertbazin syndrome and belongs to a group of rare cancer that involves the skin. Earlystage mfctcl stages ia and ib is most often managed in both dermatology and multidisciplinary settings. It is a rare nonhodgkins lymphoma of mature, skinhoming, clonal, malignant t lymphocytes, usually observed in mid to late adulthood, that initially presents in the skin as patches, plaques, tumors, or generalized erythema erythroderma and can involve the lymph nodes and peripheral blood. Especially in early lesions of mycosis fungoides, i. The clinicopathological challenges of patchplaque stage of mycosis fungoides. Mf, which has been termed the great imitator, presents with a variety of clinical features and nonspecific histological findings, especially in early lesions.
The prognosis for hypopigmented mycosis fungoides is much better than for. Physicians often have difficulty diagnosing a generalized rash because many different conditions produce similar rashes, and a single condition can result in different rashes with varied appearances. Nahla shihab dermatology and venereology resident physician, cipto mangunkusumo national hospital, universitas. Patients with classic mf, as originally described by alibert and bazin two centuries ago, initially present with erythematous patches andor plaques picture 1ab, which represent the early stage of mf. In children, hypopigmented patch manifests frequently. Mf is a mature t cell nonhodgkin lymphoma with presentation in the skin but with potential involvement of the nodes, blood, and viscera.
Clinically, the patches and plaques vary in size and shape, have a scaly atrophic surface, and are often. Over the past 30 years, numerous atypical types of. Erythematous scaly patches and plaques on the trunk and extremities hassab elnaby h, md, elkhalawany m, md. Mycosis fungoides mf is a cutaneous tcell nonhodgkins lymphoma. For example, mycosis fungoides cutaneous tcell lymphoma mimics eczema in its early stages and is rarely diagnosed correctly at initial presentation 35. Mycosis fungoides mf, being the most common form of cutaneous tcell lymphoma, is characterized by a wide variety of clinical findings. Mf is also considered as one of the great imitators in dermatology and dermatopathology. Mycosis fungoides mf is the most common primary cutaneous lymphoma in children. Originally described by alibert in 1806, mf is classically a disease of adults, although children and adolescents can be affected, and it typically has a. Mycosis fungoides although a cutaneous tcell lymphoma can immitate many dermatological disorders. From the previous clinical and histopathological, the diagnosis of cutaneous tcell lymphoma with porokeratosis like lesions was reached.
It has three clinical stages beginning with a patch phase, the stage at which this patient presented, progressing to a plaque phase and eventually to the tumour stagewhich carries the worst prognosis. Mycosis fungoides presenting with papules as the only clinical manifestation is a rare variant of the disease. Mycosis fungoides is the most common form of cutaneous tcell lymphoma mfctcl. It affects men more than women and usually occurs in individuals over the age of 20 years, although it may also occur in children and adolescents. The meaning of mycosis fungoides is mushroomlike fungal disease, which refers to mushroom fungus look of the skin in the advanced stages of this disease. The annular lesions imitated psoriasis, tinea, syphilis and the diagnosis was in dilemma. Mycosis fungoides commonly presents between the ages of 45 and 60. Clinically, the patches and plaques vary in size and shape, have a scaly. This article will be presented at the american academy of dermatology 2015 annual meeting, san francisco, ca, march 2024, 2015. Narrowband ultraviolet b phototherapy of early stage. Cutaneous tcell lymphoma with porokeratosislike lesions. Mycosis fungoides mf is the most common cutaneous t cell lymphoma ctcl. The patient should be referred to a dermatologist if the skin rash is progressive or does not resolve with observation or empiric treatment. Skin lesions include patches or plaques that may be localized or widespread, tumors, and.
Mycosis fungoides mf is the most common and indolent form of cutaneuse tcell lymphomas ctcl, that usually occurs in old adults. Hyperpigmented patches were present over the trunk in bathing trunk pattern. Asian, mycosis fungoides, narrowband uvb, phototherapy introduction mycosis fungoides mf is the most common form of cutaneous tcell lymphoma. This has led some authors to label it as the great imitator of modern. Classically, mycosis fungoides is limited to the skin. Tcell lymphoma, typically presents in its early stage as inflammatory erythematous patches or plaques.
Mycosis fungoides mf is the most common form of cutaneous tcell lymphoma. Traditionally, syphilis has been designated as the great imitator within. Start studying precancerous and malignant skin conditions melanoma, kaposis, mycosis fungoides, acanthosis nigricans. We are presenting a case report of patient with mycosis fungoides, stage iia.
A niue presentation of two cases with acroperiorbital lceration and an aggressive clinical course mol iomark diagn. On immunohistochemical staining, the lymphocytes were shown to be positive for staining with cd4 fig 4. It looks like a short 515 mm, linear or curved gray line and may end in a tiny vesicle. Learn vocabulary, terms, and more with flashcards, games, and other study tools. A, physical examination revealed 2, irregular, erythematous patches on the sunprotected skin of. Mycosis fungoides mf, the most common cutaneous tcell lymphoma, typically presents in its early stage as inflammatory erythematous patches or. As both clinical and dermatopathological findings in mycosis fungoides occasionally closely imitate other dermatoses, correct diagnosis may be a challenge both for clinicians as well as dermatopathologists. However, multiple clinicopathological variants of mf have been reported and a considerable number of reports have documented mf lesions mimicking different inflammatory. Mycosis fungoides mf is a cutaneous tcell lymphoma. Quality nursing care is necessary for effective diagnosis and treatment of patients with mfctcl.
Mycosis fungoides mf is the most common primary cutaneous t cell. Cerronicoexistence of patch stage mycosis fungoides and interstitial granuloma annulare in the same patient. Mycosis fungoides pictures, staging, symptoms, causes. Selected inflammatory imitators of mycosis fungoides. Precancerous and malignant skin conditions melanoma. Traditionally, syphilis has been designated as the great imitator within different. Hypopigmented mycosis fungoides should be regarded as a subtype of mycosis fungoides, insofar as it presents some peculiar characteristics that contrast with the clinical features of. Mycosis fungoides is a rare disease that is part of a larger group of conditions known as cutaneous tcell lymphomas and is likely caused by genetic and epigenetic changes in the dna of affected. Several distinct clinical forms of mycosis fungoides have been described. Mycosis fungoides mf is the most common primary cutaneous t cell lymphoma, which is characterised in its early stages by epidermotropism of small to mediumsized t lymphocytes with cerebriform.
Pagetoid reticulosis pr, also known as woringerkolopp disease, is a form of cutaneous tcell lymphoma that demonstrates striking epidermotropism on histologic examination. Erythematous scaly patches and plaques on the trunk and. Mycosis fungoides mf is the most common primary cutaneous t cell lymphoma, which is characterised in its early stages by epidermotropism of small to mediumsized t lymphocytes with cerebriform nuclei. Perspectives in dermatopathology histologic mimickers of. While the plaque and tumor stages are diagnosed with relative ease, the diagnosis of mf in the patch stage continues to be a vexing issue to both clinicians and pathologists alike.
Multiple verrucous plaques present over the palms with. Mycosis fungoides is a great imitator both clinically and histopathologically. Most patients with hypopigmented mycosis fungoides are younger than patients typically diagnosed with classical mycosis fungoides. Mycosis fungoides mf, the most common cutaneous tcell lymphoma, typically presents in its early stage as inflammatory erythematous patches or plaques, with epidermotropism as the histopathologic hallmark of the disease. Persistent rash not affected by steroids clinical advisor. Author links open overlay panel emmilia hodak md a b iris amitaylaish md a b. Department of dermatology, university of california, san francisco, usa. This pattern of inflammation is highly suspicious for mycosis fungoides mf, a form of cutaneous tcell lymphoma ctcl. Because mf develops slowly over several years and may have a variety of clinical presentations, including itchy patches, plaques or tumors that may be confused with common benign. Mycosis fungoides mf is the most common subtype of cutaneous tcell lymphoma. Mycosis fungoides, the most common primary cutaneous lymphoma, may present with a broad spectrum of clinical features. Mycosis fungoides mf, the most common subtype of cutaneous t cell lymphoma ctcl, has been referred to as one of the great imitators due to the heterogeneity of its cutaneous manifestations. Mycosis fungoides pronounced mycohsis fungoydeez is the most common form of a type of blood cancer called cutaneous tcell lymphoma. Differential diagnoses to consider include infections, skin lymphomamalignancies, inflammatory dermatoses, nutritional deficiencies, and mechanical causes of tissue damage.
A considerable number of reports have documented mycosis fungoides mf mimicking other. Because mf develops slowly over several years and may have a variety of clinical presentations, including itchy patches, plaques or tumors that may be confused with common benign conditions such as eczema and psoriasis, the disease presents a diagnostic challenge. To determine epidemiologic features and patients characteristics of mf in isfahan iran. A 60 year old man presented to our hospital with generalized annular plaques, few with verrucous surface.
Early patch phase mycosis fungoides in a 51yearold woman. According to its natural course and prognosis, mf is classified into early stage ia, ib and iia and advanced. Traditionally, three stages have been described the patch, plaque, and tumor. Introduction mycosis fungoides mf, the most common subtype of cutaneous t cell lymphoma ctcl, has been referred to as one of the great imitators due to the heterogeneity of its cutaneous manifestations. Hypopigmented mycosis fungoides should be regarded as a subtype of mycosis fungoides, insofar as it presents some peculiar characteristics that contrast with the clinical features of the classical form. The great imitator vijaya sajjan, manisha chandela, ashok maharudrayya pandit. We performed a retrospective study in mf clinic of alzahra hospital that is the main center for treatment of mf.