Mycosis fungoides simulating acanthosis nigricans

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• Mycosis fungoides is the most common type of cutaneous T-cell lymphoma.
• The plaque stage is a common presentation, typically characterized by well-demarcated erythematous patches or plaques.
• Differential diagnosis can be challenging, especially in atypical presentations.

Observation:

• An unusual papillomatous variant of the plaque stage of mycosis fungoides was observed.
• Clinically, this variant presented with features mimicking acanthosis nigricans.
• Histopathological examination revealed a monomorphous proliferation of blast-like cells in the dermis.

Findings:

• The dermal infiltrates showed minimal epidermal infiltration, distinguishing it from classic mycosis fungoides.
• The neoplastic cells were blast-like, suggesting an aggressive component or variant.
• The papillomatous morphology and clinical resemblance to acanthosis nigricans represent an atypical presentation.

Implications:

• This case highlights the importance of considering mycosis fungoides in the differential diagnosis of lesions resembling acanthosis nigricans.
• Recognition of this variant may aid in earlier diagnosis and appropriate management of cutaneous T-cell lymphoma.
• Further research into the specific characteristics and behavior of this papillomatous variant is warranted.