Aun JA, Patel HS, Patel KK, Cashman J, Bailey E. Perplexing Rash: Challenges to Diagnosis and Management of Mycosis Fungoides. J Am Osteopath Assoc 2018;118(7):472–478. doi: 10.7556/jaoa.2018.101.
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Mycosis fungoides is the most ubiquitous form of cutaneous T-cell lymphoma. Diagnosis is arduous, as early phases often resemble common inflammatory dermatoses. The principal histologic features of MF include medium to large-sized cerebriform mononuclear cells in single or small clusters in the epidermis. Treatment modalities are prodigious and relapses are common. The authors present a case of a 69-year-old man with mycosis fungoides, followed by a review of diagnostic modalities and phototherapeutic interventions for patients with this condition. According to literature reports, monochromatic excimer light therapy is the most advantageous and well-tolerated phototherapy modality for patients with early patch stage mycosis fungoides.
a A total of 4 points are required for the diagnosis of mycosis fungoides based on any combination of points from the clinical, histopathologic, molecular biologic, and immunopathologic criteria.
b Lymphoid atypia is defined as cells with enlarged hyperchromatic nuclei and irregular or cerebriform nuclear contours.
c Contact laboratory to determine specimen required (eg, fresh-frozen tissue, formalin-fixed paraffin block).
d Contact laboratory to determine specimen required (eg, 5-mm punch biopsy submitted in tissue culture medium not frozen or fixed).
e T-cell antigen deficiency confined to the epidermis.
Abbreviation: PCR, polymerase chain reaction.
Source: Reprinted with permission from the Journal of the American Academy of Dermatology, Vol 53, Pimpinelli N, Olsen EA, Santucci M, et al, Defining early mycosis fungoides, 1053-1063, 2005, with permission from Elsevier.
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