Solitary mycosis fungoides treated with photochemotherapy: A case report

Abstract

Mycosis fungoides (MF) is the most frequent diseases among cutaneous T-cell Lymphoma (CTCL). MF is categorized as being patch, plaque, or tumor stage, but patients may concurrently have more than one type of the lesion. Solitary or unilesional mycosis fungoides is a variant of MF characterized by a single lesion involving less than 5% of total body surface skin area. Clinical feature is single erythematous plaque occurs anywhere on the body such as scalp, face, trunk, upper and lower extremities. Histopathology is similar to MF which has atypical lymphoid infiltrate with epidermotropism, possible adnexal involvement. Many cases report presented relationship among MF, koebner phenomenon and cutaneous infection. However solitary MF usually has an indolent course and good prognosis. There are various therapeutic approaches to solitary MF such as radiotherapy, surgical excision, photodynamic therapy and topical corticosteroid. We report an 84-year-old woman presented with solitary scaly hyperkeratotic erythematous plaque with minimal erosions on left palm for 1 year. She had history of thorn injury at left palm before the lesion developed. The histopathological study, immunohistochemistry and T-cell receptor (TCR) gene rearrangement were compatible with MF. She was treated by topical psoralen plus UVA (PUVA) with resolved of lesion after 6 months of treatment without any side effect.