This 90-year-old man developed a large asymptomatic red tumor near his right ear in June, 2002. Shortly after he noticed a red patch on his left arm. Skin biopsy in July, 2002 showed a CD30 negative peripheral T-cell lymphoma. In September he received local irradiation followed by severe radiation dermatitis. Although the tumors cleared, new plaques and nodules began to develop on his chest, abdomen, back, groin, arms, and legs. He had occasional night sweats and fatigue but no fever. This patient is an example of the d'emblee form of mycosis fungoides in which widespread tumors erupt without the preceding patch and plaque stage disease.
5 cm dusky red round indurated plaque with crusting