Zosteriform Mycosis Fungoides: A Case Report and Literature Review

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• Primary cutaneous lymphomas are common, with mycosis fungoides (MF) being the most frequent cutaneous T-cell lymphoma.
• Zosteriform distribution of MF is rare, often misdiagnosed due to its resemblance to other dermatoses.
• This presentation complicates diagnosis and management, necessitating a high index of suspicion.

Purpose of the Study:

• To highlight the diagnostic challenges and clinical presentation of zosteriform mycosis fungoides.
• To report a case of a patient misdiagnosed for a decade with a rare MF variant.
• To review the literature on zosteriform MF, including potential triggers and treatment outcomes.

Main Methods:

• Case report of a 29-year-old woman with a decade-long history of misdiagnosed rash.
• Clinical evaluation, histopathologic examination of skin biopsies, and response to therapy.
• Literature review of zosteriform mycosis fungoides.

Main Results:

• The patient presented with a unilateral, itchy, painful rash evolving into a resistant scaly plaque.
• Histopathology suggested large plaque parapsoriasis, leading to a diagnosis of early-stage mycosis fungoides.
• Partial improvement was observed with methotrexate and corticosteroids, indicating variable treatment responses.

Conclusions:

• Zosteriform mycosis fungoides is a rare, diagnostically challenging variant with a generally good prognosis.
• Thorough diagnostic evaluation is essential for accurate diagnosis and management.
• Further research is needed to elucidate pathogenesis and optimize therapeutic strategies for zosteriform MF.