A clinical case report on Mycosis Fungoides

Abstract

Background and Objectives: This case report highlights an aggressive and resistant biological course in a patient with mycosis fungoides, which resulted in a poor prognosis despite multiple therapies. The patient ultimately required aggressive chemotherapy due to systemic involvement.Case Presentation: A 64-year-old Hispanic male presented to the dermatology clinic for evaluation of hardened, erythematous lesions distributed across his trunk and upper extremities, accompanied by generalized pruritus. He reported that the lesions had been present for approximately two years and had increased in size over time. Pathology results from punch biopsies taken from the lesions confirmed a diagnosis of mycosis fungoides. Treatment with topical glucocorticoids and systemic retinoids was initiated; however, after six months, the disease progressed to involve lymph nodes. The patient underwent multiple rounds of radiation therapy for advanced lesions and was subsequently referred to an oncologist for further treatment due to the poor prognosis.Discussion: Mycosis fungoides is a form of T-cell lymphoma that is typically confined to the cutaneous tissue. A high expression of CD30+ lymphocytes in the epidermis is indicative of transformation into advanced large cell lymphoma, suggesting an aggressive clinical course and an overall poor prognosis. While mycosis fungoides is generally considered a low-grade, indolent malignancy, this case demonstrates an aggressive and resistant biological course, leading to a significantly poorer outcome.

Keywords

• skin rash
• mycosis fungoides
• cutaneous t-cell lymphoma