Granulomatous mycosis fungoides with hypohidrosis mimicking lepromatous leprosy

Abstract

Granulomatous mycosis fungoides (GMF) is a rare type of cutaneous T cell lymphoma. A 38-year-old married male presented with decreased sweating all over the body for last 8 years, progressive redness and scaling over body for 2 years and multiple noduloulcerative lesions over the body for 1 year. Cutaneous examination revealed generalized erythema and scaling with poikilodermatous changes over chest and upper back along with multiple noduloulcerative lesions. Skin biopsy from a nodular lesion revealed dense granulomatous infiltrate of atypical lymphocytes with epidermotropism and sparing of appendages. Diagnosis of GMF was made. Computed tomographic scan of thorax, abdomen and pelvis revealed axillary and inguinal lymphadenopathy. Immunohistochemistry revealed leukocyte common antigen and CD3 positivity suggestive of T cell origin. Patient was started on CHOP (Cyclophosphamide, Hydroxydaunorubicin, Oncovin and Prednisolone) regimen of chemotherapy with marked improvement after three cycles of chemotherapy. This case had some clinical resemblance to lepromatous leprosy.

Granulomatous mycosis fungoides, a rare subtype of cutaneous T-cell lymphoma

“… 4 The correct diagnosis is based on histopathologic features, immunohistochemistry, and TCR rearrangement. 4 , 5 According to recent studies, extracutaneous manifestations are more frequent in GMF and occur earlier than in classical MF. Five-year survival rate of GMF is 66% worse than that in classical MF.…”