Mycosis fungoides is the most common primary cutaneous T-cell lymphoma. Although mycosis fungoides affects patients of all skin tones, mycosis fungoides has a higher incidence in patients with skin of color. Patients with skin of color who are diagnosed with mycosis fungoides have worse outcomes and poor prognosis compared with patients with lighter skin tones. Mycosis fungoides is difficult to diagnose in patients with skin of color as rare subtypes or clinical presentations are commonly seen in these populations. Increased awareness of the presentation of mycosis fungoides in skin of color and early detection could address the higher rates of morbidity and mortality in these populations.

This is a case of a patient presenting with pruritic dark plaques that erupted on the upper extremities and the left inner thigh. The patient is otherwise asymptomatic with no other acute concerns. A multiple-choice question is presented and readers will be challenged to diagnose this patient based on the case presentation, symptoms, and patient history. An answer is given followed by a discussion of the diagnosis, clinical features, and therapeutic management.