Caso para diagnóstico

Abstract

HISTORY OF THE DISEASEECSS, an 18-year old female born and living in Manaus in the Brazilian state of Amazonas presented with a single, well-defined erythematous, desquamative plaque with a maximum diameter of 4 cm, situated in the abdominal region, which had been present for the past year (Figure 1). The patient stated that she had not used any medication previously. A skin biopsy was performed for diagnostic evaluation.At histopathology, the hematoxylin-eosinstained sections showed the presence of a group of mononuclear cells containing atypical lymphocytes and mild spongiosis. In the papillary dermis an infiltrate of perivascular lymphoid cells was found reaching the epidermis. No further alterations were identified in the rest of the dermis or hypodermis (Figures 2 and 3). The paraffin block was sent for immunohistochemical evaluation, which showed that the majority of the lymphoid cells present were CD3-positive in addition to being CD20 negative; CD45RO-positive; CD30-negative; and AE1/AE3-negative. The set of histopathological and immunohistochemical findings were conclusive for a diagnosis of unilesional mycosis fungoides.An Bras Dermatol. 2010;85(6):927-9.The patient was submitted to laboratory evaluation (full blood count, glucose and clinical chemistry) and systemic evaluation (chest x-ray, bone xray, a magnetic resonance imaging scan of the head and computed tomography).No abnormalities were found.