Unmasking tumors: A case of a CD30-Negative MycosisFungoides masquerading as Erythema NodosumLeprosumin a filipino male

ABSTRACT

@#Mycosis Fungoides is the most common type of primary cutaneous lymphoma. Early in its course, it usually presents as erythematous patches and plaques similar to a lot of cutaneous conditions. A 68-year-old male presented with a 13-year history of multiple erythematous patches and plaques on the arms and trunk. The lesions were pruritic and chronically relapsing over the years, temporarily relieved by topical corticosteroids. Thereafter, there was onset of multiple nodules on the trunk, extremities and face. Initial biopsy was done by a different dermatologist, revealed Hansen’s Disease, Borderline Borderline spectrum. Fitefaraco stain was positive but no bacillary index was given. The patient was subsequently started on rifamcpicin 600mg/capsule once a day, Ofloxacin 400mg/tablet once a day, and Minocycline 100mg/capsule once a day. The lesions were noted to worsen, eventually developing ulcerations over the trunk and extremities prompting referral to our institution. The biopsy results were as follows Cutaneous T-Cell Lymphoma, diffuse cluster of differentiation (CD) 3 staining, focal CD20 staining, and negative FiteFaraco stain. The histopathologic findings combined with the clinical presentation led to the diagnosis of Mycosis Fungoides. He was then referred to medical oncology for proper staging and definitive management. The prognosisof Mycosis Fungoides is generally dependent on the stage as determined by the extent of skin involvement as well as presence of lymph node invasion and/or metastasis.