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April 2016

Cutaneous T-Cell Lymphoma Misdiagnosed as Lipodermatosclerosis

Author Affiliations
  • 1Division of Dermatology, Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky
  • 2Associate Editor, JAMA Dermatology
JAMA Dermatol. 2016;152(4):487-488. doi:10.1001/jamadermatol.2015.6106

Herein, we describe an obese woman with a 2-year history of a persistent indurated plaque on the right calf misdiagnosed as lipodermatosclerosis, while the true diagnosis was mycosis fungoides (MF). To our knowledge, there have been no other cases of MF mimicking lipodermatosclerosis reported.

A woman in her 60s presented with an indurated, erythematous, nontender plaque on her right leg. There was associated aching pain and numbness, but no peripheral edema was noted, and her ankle was not involved. She had previously been evaluated by an internist, a vascular surgeon, a local dermatologist, and a dermatologist at a tertiary referral center, all of whom diagnosed lipodermatosclerosis based on her clinical examination and suggested topical corticosteroid therapy and compression. The vascular surgeon had referred the patient to an oncologic surgeon for a biopsy, but a biopsy was not performed owing to concern about poor healing. The dermatologic consultation had noted “eczematous” changes on the trunk and thighs that responded partially to topical corticosteroids. Vascular studies had revealed venous insufficiency in both legs but worse on the unaffected leg.

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