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February 1997

An Asymptomatic Scaly Plaque

Author Affiliations

National Naval Medical Center, Bethesda, Md

Arch Dermatol. 1997;133(2):231-232. doi:10.1001/archderm.1997.03890380103017

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?

DIAGNOSIS:  Unilesional mycosis fungoides (MF).

HISTOPATHOLOGIC FINDINGS  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.

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