Diagnosing mycosis fungoides

Las Vegas

- The most common diagnosis of cutaneous T-cell lymphoma diagnosis in the practice of dermatology is mycosis fungoides (MF), according to Peter W. Heald, M.D., professor of dermatology, Yale School of Medicine, New Haven, Conn., who spoke here at the 27th Annual Fall Clinical Dermatology Conference.

The strength of the diagnosis of MF is based on the physical examination of primary lesions and distribution, and each lesion should be categorized as classic, consistent or atypical.

When doctors suspect MF in a classic lesion, Dr. Heald says, they should check the distribution, especially in lesions found on sun-shielded areas of the body, such as buttocks, breasts, axillary and inguinal areas. Also, doctors should look for brow infiltration and leonine facies when classic lesions are found on the face.

For atypical lesions, doctors should check distribution in the extremities, such as palms, soles, and distal arms and legs.

If the morphology and biopsy are consistent with MF or suggestive of MF, the dermatologist cannot rule out the possibility of MF, Dr. Heald says. DT

Disclosures: Dr. Heald reports no relevant disclosures.