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DEAR EDITOR, A 22-year-old white man was evaluated for a mildly pruritic scaly rash of 6 years' duration, which began on his chest and recently spread to the axillae and back. He initially presented to his primary doctor, who provided him with topical steroids without benefit. The eruption never ulcerated. Examination revealed pink annular and polycyclic patches on the chest, axillae and flanks without nodules, tumours or adenopathy. There was very faint scale at the borders of the lesions. A potassium hydroxide stain was negative for dermatophytes. Two biopsies revealed a CD8 predominant epidermotropic infiltrate of atypical lymphocytes with a clonal T-cell receptor rearrangement. Complete staging revealed stage IA disease. The indolent behaviour is consistent with mycosis fungoides with aberrant CD8+ phenotype. Current treatment includes a potent topical corticosteroid and close follow-up.

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