An Uncommon Manifestation of Mycosis Fungoides (MF) with Annular Lesions
AbstractMycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma, which often appears in the form of patches, plaques, and tumors as originally described by Alibert and Bazin. The manifestation of MF as annular lesions is uncommon, and herein we report one of those cases. A 54-year-old woman complaining of itchy skin lesions from three years before, came to our clinic with no response to topical steroids. In skin examination, there were annular lesions with erythematous slightly raised borders, and some scattered erythematous thin plaques in trunk and extremities with a predilection to lower extremities. Epidermal and poikilodermic changes were not evident. There were no lymphadenopathy and hepatosplenomegaly. Biopsies were obtained from three different lesions and the diagnosis of all samples was consistent with MF. A diagnosis of stage 1B of MF was made and the patient went under oral psoralen and ultraviolet A (PUVA) therapy. MF has different clinical manifestations that can be confused with other inflammatory dermatological disorders. Until now, less than 10 cases of MF with annular lesions have been reported in the English literatures, and most of them initially were under treatment with other differential diagnosis of annular lesion than MF
de Masson A, Battistella M, Vignon-Pennamen MD, Cavelier-Balloy B, Mouly F, Rybojad M, et al. Syringotropic mycosis fungoides: Clinical and histologic features, response to treatment, and outcome in 19 patients. J Am Acad Dermatol 2014; 71(5): 926-34.
Ehsani AH, Azizpour A, Noormohammadpoor P, Seirafi H, Farnaghi F, Kamyab-Hesari K, et al. Folliculotropic mycosis fungoides: Clinical and histologic features in five patients. Indian J Dermatol 2016; 61(5): 554-8.
Crowley JJ, Nikko A, Varghese A, Hoppe RT, Kim YH. Mycosis fungoides in young patients: Clinical characteristics and outcome. J Am Acad Dermatol 1998; 38(5 Pt 1): 696-701.
Zackheim HS, McCalmont TH. Mycosis fungoides: The great imitator. J Am Acad Dermatol 2002; 47(6): 914-8.
Lim DS, Murphy GM, Egan CA. Mycosis fungoides presenting as annular erythema. Br J Dermatol 2003; 148(3): 591.
Cogrel O, Boralevi F, Lepreux S, Vergier B, Merlio JP, Taieb A, et al. Lymphomatoid annular erythema: A new form of juvenile mycosis fungoides. Br J Dermatol 2005; 152(3): 565-6.
Moura FN, Thomas L, Balme B, Dalle S. Mycosis fungoides mimicking an annular erythema. Clin Exp Dermatol 2009; 34(8): e581-e583.