REPORT OF A CASE
A 44-year-old man presented to our clinic for evaluation of a single asymptomatic lesion on his right flank that had been present for 4 months. He reported that the lesion had quickly arisen but had remained unchanged for the past 3 months. Physical examination revealed a 1.1×1.5-cm, erythematous, slightly scaly plaque with central clearing and atrophy (Figure 1). He had no other cutaneous lesions. He had been evaluated 2 months previously, and a biopsy had been performed on a portion of the lesion to rule out basal cell carcinoma.An excisional biopsy was performed (Figure 2 and Figure 3).What is your diagnosis?
Unilesional mycosis fungoides (MF).
The biopsy specimen revealed compact orthokeratosis with a slightly atrophic epidermis. There was a dermal infiltrate of atypical, hyperchromatic lymphocytes that had convoluted nuclei with significant epidermotropism and formation of Pautrier microabscesses.
Evans L, Mackey SL, Vidmar DA. An Asymptomatic Scaly Plaque. Arch Dermatol. 1997;133(2):231-232. doi:10.1001/archderm.1997.03890380103017