Oral mycosis fungoides

Mycosis fungoides (MF) is the most common subtype of cutaneous T cell lymphoma. Oral presentation is both rare and highly variable, often denoting advanced disease stage. A female patient in her 70s was referred regarding painful recurrent palatal ulceration of 6 months' duration, which was significantly impacting her quality of life. She had known MF treated with oral bexarotene, electron beam therapy and localised radiotherapy. Oral examination revealed two shallow palatal ulcers, and incisional biopsy revealed an atypical stromal and intraepithelial CD3+ T lymphocyte population with a predominance of CD8+ T cells; PCR revealed T cell receptor gene rearrangements demonstrating a monoclonal population whose profile was identical to that in a recent skin biopsy, indicating oral MF. Unfortunately, the patient succumbed to her disease 7 months after presentation to our unit. This case highlights that oral involvement can develop in MF and can have a significant impact on a patient's quality of life.