R. Barsoum1, K. Choong2
Mycosis fungoides (MF) is a cutaneous manifestation of T-cell lymphoma, with many rare forms that are poorly understood. One subtype, purpuric MF, has significant overlap with a bengin group of conditions known as pigmented purpuric dermatoses (PPD). The literature is sparely populated with cases linking PPD to MF, and generally fall into one of three categories: MF mimicking PPD (1), PPD evolving into MF(2) and PPD mimicking MF (3).
We intend to present an oral case of a 51 year old immunocompetent man who presents with multiple eyrthematous to rust coloured eruptions who was initially diagnosed and treated as PPD. Through histology, his case became more complex as the pathologist suggested features of MF. We discuss the results of his T cell gene rearrangement studies and new diagnosis of purpuric MF. This case aims to draw discussion from our colleagues about their experience with this rare subtype of MF, and to draw suggestions which can help clarify the natural timeline of this poorly understood condition.
Martinez W, del Pozo J, Vasquez J et al. Cutaneous Tcell lymphoma presenting as disseminated, pigmented, purpura-like eruption. Int J Dermatol 2001;40:133-52.
Lipsker D, Cribier B, Heid E et al. Pigmented purpuric dermatitis revealing cutaneous lymphoma. Ann Dermatol Venereol 1999; 126: 321-6.
Hanna S, Walsh N, D’Intino Y, Langley RG. Mycosis fungoides presenting as pigmented purpuric dermatitis. Pediatr Dermatol. 2006 Jul-Aug; 23(4): 350-4.