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Journal of General Internal Medicine

, Volume 34, Issue 11, pp 2669–2674 | Cite as

An Elusive Case of Mycosis Fungoides: Case Report and Review of the Literature

  • Vincent A. PallazolaEmail author
  • Gerard Deib
  • Soni Abha
  • Rabih M. Geha
  • Kimiyoshi Kobayashi
Clinical Practice: Clinical Vignettes

Abstract

Erythroderma refers to a spectrum of skin diseases resulting in diffuse erythema and scaling encompassing ≥ 90% of the body surface area. The differential diagnosis ranges from primary dermatologic diseases such as atopic dermatitis and psoriasis to potentially deadly causes such as staphylococcal toxic shock syndrome, toxic epidermal necrolysis, and malignancy. Cutaneous T cell lymphoma (CTCL) is an uncommon but highly morbid cause of erythroderma. This non-Hodgkin lymphoma remains a diagnostic challenge due to its variable clinical presentation and varied histologic features. Mycosis fungoides (MF) is the most common form of CTCL. Making a timely diagnosis is challenging as it may mimic inflammatory diseases of the skin including eczema, psoriasis, lichen planus, and cutaneous lupus. We present a case of a 58-year-old man who presented with 5 years of cutaneous symptoms and several months of fevers and night sweats, ultimately diagnosed as MF. Owing to diffuse CD30 positivity, he was a candidate for brentuximab vedotin, an antibody-drug conjugate medication that selectively targets the CD30 antigen. This resulted in an excellent therapeutic response.

KEY WORDS

cancer dermatology clinical image 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Vincent A. Pallazola
    • 1
    Email author
  • Gerard Deib
    • 2
  • Soni Abha
    • 3
  • Rabih M. Geha
    • 4
    • 5
  • Kimiyoshi Kobayashi
    • 1
  1. 1.Department of MedicineJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of RadiologyJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Department of DermatologyJohns Hopkins University School of MedicineBaltimoreUSA
  4. 4.Department of MedicineUniversity of California San FranciscoSan FranciscoUSA
  5. 5.Medical Service, San Francisco Veterans Affairs Medical CenterSan FranciscoUSA

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