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Mycosis Fungoides : Patch Stage

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Mycosis Fungoides (MF) - Patch Stage : MF is divided into three stages - patch, plaque and tumor stage. All stages may be present simultaneously in a patient and some patients do not progress beyond the patch stage.

The early lesions (patch stage) are pink or red, irregular, asymmetrical, randomly distributed, and variably scaly and are accompanied by pruritus. Many lesions appear atrophic with smooth and shiny skin. They are superficial at first but become confluent and thicker later. The most common sites are sun-protected (non-exposed) areas such as trunk, limb girdles, buttocks, breasts, and groins. The size of patches ranges from 1 cm to >15 cm.

In the majority of the patients who present with patches involving small areas of skin, the disease pursues an indolent course even without treatment. In a small percentage of patients, the neoplastic lymphocytes acquire the ability to proliferate in the dermis and produce plaques and tumors.

The photograph shows irregular erythematous lesions of the patch stage on the back of this patient. The clinical differential diagnosis of MF is wide and includes: eczema, psoriasis, small or large-plaque parapsoriasis, discoid, atopic or contact allergic dermatitis, adverse drug reactions, dermatophytosis, or nummular dermatitis.

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