DermAtlas: Online Dermatology Image Library dermatology image,mycosis fungoides,lymphoma, T-cell,lymphoma, T-cell,lymphoma, T-cell,lymphoma, T-cell,pityriasis lichenoides,lymphoma, T-cell,erythroderma,lymphoma, T-cell

© 2001-2010, DermAtlas	*Image Name:*	mycosis_fungoides_1_090731	*File Type:*	jpg
	*Diagnosis:*	MYCOSIS FUNGOIDES / LYMPHOMA, T-CELL	*Category:*	neoplasm, malignant / papulosquamous eruptions
	*Body Site:*	arm	*Age:*	52 years
	*Contributor:*	Sherry Guralnick Cohen, CRNP-F
	*Description:*	discrete and confluent well demarcated hypopigmented minimally scaly patches
	*Comments:*	This healthy 52-year-old man was evaluated for asymptomatic hypopigmented patches which waxed and waned on his trunk and extremities for 3 years. A skin biopsy showed changes typical of cutaneous T-cell lymphoma.
	*Related Images:*	All related Images mycosis_fungoides_3_090731 mycosis_fungoides_2_090731

© 2001-2010, DermAtlas	*Image Name:*	mycosis_fungoides_2_090731	*File Type:*	jpg
	*Diagnosis:*	MYCOSIS FUNGOIDES / LYMPHOMA, T-CELL	*Category:*	neoplasm, malignant / papulosquamous eruptions
	*Body Site:*	buttock / hip	*Age:*	52 years
	*Contributor:*	Sherry Guralnick Cohen, CRNP-F
	*Description:*	discrete and confluent well demarcated hypopigmented minimally scaly patches
	*Comments:*	This healthy 52-year-old man was evaluated for asymptomatic hypopigmented patches which waxed and waned on his trunk and extremities for 3 years. A skin biopsy showed changes typical of cutaneous T-cell lymphoma.
	*Related Images:*	All related Images mycosis_fungoides_3_090731 mycosis_fungoides_1_090731

© 2001-2010, DermAtlas	*Image Name:*	mycosis_fungoides_3_090731	*File Type:*	jpg
	*Diagnosis:*	MYCOSIS FUNGOIDES / LYMPHOMA, T-CELL	*Category:*	neoplasm, malignant / papulosquamous eruptions
	*Body Site:*	arm	*Age:*	52 years
	*Contributor:*	Sherry Guralnick Cohen, CRNP-F
	*Description:*	discrete and confluent well demarcated hypopigmented minimally scaly patches
	*Comments:*	This healthy 52-year-old man was evaluated for asymptomatic hypopigmented patches which waxed and waned on his trunk and extremities for 3 years. A skin biopsy showed changes typical of cutaneous T-cell lymphoma.
	*Related Images:*	All related Images mycosis_fungoides_2_090731 mycosis_fungoides_1_090731

© 2001-2010, DermAtlas	*Image Name:*	mycosis_fungoid_1_080613	*File Type:*	jpg
	*Diagnosis:*	MYCOSIS FUNGOIDES / LYMPHOMA, T-CELL	*Category:*	neoplasm, malignant / papulosquamous eruptions
	*Body Site:*	total body / arm axilla (armpit)	*Age:*	35 years
	*Contributor:*	Kosman Sadek Zikry, MD
	*Description:*	widespread scattered hyperpigmented papules and plaques
	*Comments:*	A 35-year-old man was evaluated for a widespread scattered eruption comprised of itchy hyperpigmented papules and plaques. A skin biopsy revealed mycosis fungoides.

© 2001-2010, DermAtlas	*Image Name:*	mycosis_fungoides_1_060220	*File Type:*	jpg
	*Diagnosis:*	MYCOSIS FUNGOIDES / PITYRIASIS LICHENOIDES	*Category:*	neoplasm, malignant / papulosquamous eruptions
	*Body Site:*	thigh / buttock	*Age:*	9 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	Histologic sections of skin show regular (psoriasiform) epidermal acanthosis with overlying orthokeratosis. Within the epidermis, there is a population of mononuclear cells, tagging along the dermal/epidermal junction and extending into the epidermis in a pattern of epidermotropism. These cells appear enlarged with perinuclear halos. The dermis shows mild fibrosis and has an interstitial infiltrate with similar mononuclear cells.
	*Comments:*	This 9-year-old boy has a chronic, eczematous eruption over his thighs and buttocks. It has not responded well to topical steroids but diminishes with light exposure. The clinical impression includes pityriasis lichenoides chronica and parapsoriasis, but the biopsy was taken to rule out mycosis fungoides. Mycosis fungoides is unusual in the pediatric population, and when it occurs, it is often CD8+. Unfortunately, just as the clinical diagnosis is challenging, often the histologic diagnosis is equally challenging. Patients with contact dermatitis or PLEVA can, on occasion, have cytologic atypia in their infiltrate. Also, clonal populations using molecular assays have been demonstrated in benign inflammatory conditions. Therefore, serial biopsies and clinical monitoring are often necessary to come to the correct diagnosis. The histology in this case is very worrisome for mycosis fungoides. The TCR gene rearrangement analysis came back polyclonal.
	*Related Images:*	All related Images mycosis_fungoides_3_060220 mycosis_fungoides_2_060220 mycosis_fungoides_4_060220

© 2001-2010, DermAtlas	*Image Name:*	mycosis_fungoides_4_060220	*File Type:*	jpg
	*Diagnosis:*	MYCOSIS FUNGOIDES / PITYRIASIS LICHENOIDES	*Category:*	neoplasm, malignant / papulosquamous eruptions
	*Body Site:*	thigh / buttock	*Age:*	9 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	symmetric discrete and confluent pink hypopigmented patches
	*Comments:*	This 9-year-old boy had a chronic, eczematous eruption over his thighs and buttocks. It had not responded well to topical steroids but diminishes with light exposure. The clinical impression includes pityriasis lichenoides chronica and parapsoriasis, but the biopsy was taken to rule out mycosis fungoides. Mycosis fungoides is unusual in the pediatric population, and when it occurs, it is often CD8+. Unfortunately, just as the clinical diagnosis is challenging, often the histologic diagnosis is equally challenging. Patients with contact dermatitis or PLEVA can, on occasion, have cytologic atypia in their infiltrate. Also, clonal populations using molecular assays have been demonstrated in benign inflammatory conditions. Therefore, serial biopsies and clinical monitoring are often necessary to come to the correct diagnosis. The histology in this case is very worrisome for mycosis fungoides. The TCR gene rearrangement analysis came back polyclonal.
	*Related Images:*	All related Images mycosis_fungoides_3_060220 mycosis_fungoides_2_060220 mycosis_fungoides_1_060220

© 2001-2010, DermAtlas	*Image Name:*	mycosis_fungoides_2_060220	*File Type:*	jpg
	*Diagnosis:*	MYCOSIS FUNGOIDES / PITYRIASIS LICHENOIDES	*Category:*	neoplasm, malignant / papulosquamous eruptions
	*Body Site:*	thigh / buttock	*Age:*	9 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	At higher power of the same lesion, one can appreciate the cytologic atypia of the infiltrate. These cells ascend into the epidermis with minimal spongiosis. Focal aggregates ("Pautrier microabscesses") are also noted. These cells have hyperchromatic convoluted nuclei.
	*Comments:*	This 9-year-old boy has a chronic, eczematous eruption over his thighs and buttocks. It has not responded well to topical steroids but diminishes with light exposure. The clinical impression includes pityriasis lichenoides chronica and parapsoriasis, but the biopsy was taken to rule out mycosis fungoides. Mycosis fungoides is unusual in the pediatric population, and when it occurs, it is often CD8+. Unfortunately, just as the clinical diagnosis is challenging, often the histologic diagnosis is equally challenging. Patients with contact dermatitis or PLEVA can, on occasion, have cytologic atypia in their infiltrate. Also, clonal populations using molecular assays have been demonstrated in benign inflammatory conditions. Therefore, serial biopsies and clinical monitoring are often necessary to come to the correct diagnosis. The histology in this case is very worrisome for mycosis fungoides. The TCR gene rearrangement analysis came back polyclonal.
	*Related Images:*	All related Images mycosis_fungoides_3_060220 mycosis_fungoides_4_060220 mycosis_fungoides_1_060220

© 2001-2010, DermAtlas	*Image Name:*	mycosis_fungoides_3_060220	*File Type:*	jpg
	*Diagnosis:*	MYCOSIS FUNGOIDES / PITYRIASIS LICHENOIDES	*Category:*	neoplasm, malignant / papulosquamous eruptions
	*Body Site:*	thigh / buttock	*Age:*	9 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	Immunohistochemical analysis demonstrates the infiltrate to consist of CD3+ T cells. Within the epidermis, they are predominantly CD4+, but some CD8+ cells are also present. CD7 appears aberrantly diminished within the epidermal component.
	*Comments:*	This 9-year-old boy has a chronic, eczematous eruption over his thighs and buttocks. It has not responded well to topical steroids but diminishes with light exposure. The clinical impression includes pityriasis lichenoides chronica and parapsoriasis, but the biopsy was taken to rule out mycosis fungoides. Mycosis fungoides is unusual in the pediatric population, and when it occurs, it is often CD8+. Unfortunately, just as the clinical diagnosis is challenging, often the histologic diagnosis is equally challenging. Patients with contact dermatitis or PLEVA can, on occasion, have cytologic atypia in their infiltrate. Also, clonal populations using molecular assays have been demonstrated in benign inflammatory conditions. Therefore, serial biopsies and clinical monitoring are often necessary to come to the correct diagnosis. The histology in this case is very worrisome for mycosis fungoides. The TCR gene rearrangement analysis came back polyclonal.
	*Related Images:*	All related Images mycosis_fungoides_2_060220 mycosis_fungoides_4_060220 mycosis_fungoides_1_060220

© 2001-2010, DermAtlas	*Image Name:*	mycoses_fungoides_erythroderma_1_041001	*File Type:*	jpg
	*Diagnosis:*	MYCOSIS FUNGOIDES / LYMPHOMA, T-CELL / ERYTHRODERMA	*Category:*	cutaneous sign of systemic disease / papulosquamous eruptions
	*Body Site:*	total body / chest abdomen / arm	*Age:*	72 years
	*Contributor:*	Sakthiraj Subramanian, MD
	*Description:*	generalized erythema and scale
	*Comments:*	This 72-year- old man with 1 year history of erythroderma and 3 month history of generalized prurutis,no loss of appetite or weight loss,on examination there was generalized lymphadenopathy and edema which was more of subcutaneous in nature.His blood work up initially revealed 86 percent lymphocytes as oppose to 2 percent neutrophils.LDH was 478 reasonable for aggressive disease.
	*Related Images:*	mycoses_fungoides_erythroderma_2_041001

© 2001-2010, DermAtlas	*Image Name:*	mycoses_fungoides_erythroderma_2_041001	*File Type:*	jpg
	*Diagnosis:*	MYCOSIS FUNGOIDES / LYMPHOMA, T-CELL / ERYTHRODERMA	*Category:*	cutaneous sign of systemic disease / papulosquamous eruptions
	*Body Site:*	total body / shoulder arm	*Age:*	72 years
	*Contributor:*	Sakthiraj Subramanian, MD
	*Description:*	generalized erythema and scale
	*Comments:*	This 72-year- old man had a 1 year history of erythroderma and 3 month history of generalized prurutis without loss of appetite or weight loss. Examination revealed generalized erythema, scale, lymphadenopathy, and edema. Skin biopsy showed changes typical of cutaneous T-cell lymphoma.
	*Related Images:*	mycoses_fungoides_erythroderma_1_041001