Mycosis fungoides presenting as hypopigmented and pigmented purpuric dermatosis-like lesions in a girl: a case report and literature review

Abstract

Mycosis fungoides (MF) is the most common skin subtype of T-cell lymphoma. Its underlying cause is not yet clearly understood, and diagnosis might be difficult since MF presents itself with symptoms similar to some other dermatologic disorders. In the current case presentation, we report a 12-year-old female with concurrent hypopigmented and pigmented purpuric dermatosis-like lesions that underwent skin biopsies and immunohistochemistry study. Microscopic findings of hyperkeratosis and mild acanthosis in addition to epidermotropism of lymphocytes with perivascular and interstitial infiltration led us to the probable diagnosis of MF. Intraepidermal lymphocyte immunohistochemistry assessments were positive for CD3 and CD4 while negative for CD8 and CD7. The peripheral blood smear revealed a normal CD4 to CD8 ratio, and the number of Sézary cells detected was insufficient to diagnose Sézary syndrome. Therefore, the final diagnosis of MF was made for this young patient. © 2022, Iranian Society of Dermatology. All rights reserved.