An Elusive Case of Mycosis Fungoides: Case Report and Review of the Literature

Abstract

Erythroderma refers to a spectrum of skin diseases resulting in diffuse erythema and scaling encompassing ≥ 90% of the body surface area. The differential diagnosis ranges from primary dermatologic diseases such as atopic dermatitis and psoriasis to potentially deadly causes such as staphylococcal toxic shock syndrome, toxic epidermal necrolysis, and malignancy. Cutaneous T cell lymphoma (CTCL) is an uncommon but highly morbid cause of erythroderma. This non-Hodgkin lymphoma remains a diagnostic challenge due to its variable clinical presentation and varied histologic features. Mycosis fungoides (MF) is the most common form of CTCL. Making a timely diagnosis is challenging as it may mimic inflammatory diseases of the skin including eczema, psoriasis, lichen planus, and cutaneous lupus. We present a case of a 58year-old man who presented with 5 years of cutaneous symptoms and several months of fevers and night sweats, ultimately diagnosed as MF. Owing to diffuse CD30 positivity, he was a candidate for brentuximab vedotin, an antibody-drug conjugate medication that selectively targets the CD30 antigen. This resulted in an excellent therapeutic response.

Mycosis Fungoides: The Great Masquerader – Trilogy Case Series

“…However, Purnamasidhi et al [11] described a case report of a 42-year-old male who presented with an ulcerated and necrotic mass in the left gluteal region. Pallazola et al [12] reported a case of a 58-year-old male with various scattered hyperpigmented patches and plaques, punched-out ulcerations, and subcutaneous nodules in different stages of skin lesions all over the body.…”

Hypopigmented Mycosis Fungoides in an 11-Year-Old Palestinian Boy

“…In our case, we describe a case of hypopigmented MF in a Palestinian child. MF in pediatrics tends to be under reported [ 8 ]. This is because at first, MF has a clinical and histopathological resemblance to other benign inflammatory disorders [ 9 , 10 ].…”

“…These can include pityriasis alba, vitiligo, pityriasis versicolor, and postinflammatory hypopigmentation [ 2 , 5 ]. Another reason for delayed diagnosis is physicians' reluctance to perform early skin biopsies in children [ 8 ]. In our presented case, diagnosis of the condition was made after approximately 9 months from the start of the dermatologic manifestations.…”