Author: Dr. Shadi Habib, Dermatologist, Ibn al-Walid Hospital, Syria, 2023. Reviewing dermatologist: Dr Ian Coulson.
Edited by the DermNet content department
A 50-year-old man presented with a 3-month history of firm tumour-like nodules on his face, scalp, back, arms and legs, approximately 1-5 cm in diameter but increasing in size. Some had started to ulcerate.
There were no skin changes preceding the tumour development and the lesions were otherwise asymptomatic. Medical and drug history was unremarkable with no other systemic symptoms and routine blood tests were normal.
Biopsy showed neoplastic proliferation of lymphoid cells, positive for CD3, CD4, CD5, CD20 and negative for CD8 and CD30.
Differential diagnoses include:
Biopsy however, suggested a malignant T-cell lymphoma, and the development of tumours without preceding patches or plaques is the presentation of tumour d'emblee mycosis fungoides.
Tumours are the initial presentation in only 10% of patients with mycosis fungoides. They commonly eventually ulcerate.
For more information, see mycosis fungoides.
Systemic treatment:
It has a poor prognosis with only a 5-year survival of 15%.
