A diagnosis of Stage IB (T2N0M0B0) MF was confirmed, and treatment with cycles of photochemotherapy (psoralen plus ultraviolet A radiation; PUVA) combined with topical corticosteroids was initiated, achieving partial clinical remission. No major changes in the skin lesions were noted following surgical excision of the lung cancer.

DISCUSSION

MF is characterized by extremely variable presentation, and reportedly mimicks at least 25 dermatoses (1). Patients usually present with patches, plaques, tumours, and/or erythroderma. EGR-like MF, has recently been described as a possible rare form of MF. EGR is a rare paraneoplastic syndrome strongly associated with various malignancies, particularly lung, breast, and oesophageal cancers. The rash consists of serpiginous, erythematous, concentric bands that can be figurate, gyrate, or annular, and are arranged in parallel rings lined by a fine, trailing edge of scale; a pattern often described as “wood grained.”

To our knowledge, only 6 cases, including the present case, of MF resembling EGR, have been reported (2–6) (Table I). The present case is the first associated with an underlying malignancy.

The neoplastic T cells present in MF are typically CD4+ and CD8–; however, there are variants in which 1 or both of these subpopulations are lost. A review indicated that cases with unusual cell populations, such as the present case, often have unique clinical presentations (7). Various clinical morphologies may be elicited by lymphocytes with the differing phenotypes. Moreover, the host responses between patients may differ, which may contribute to the various presentations (1). The patient’s underlying lung cancer, a malignancy closely related to true EGR, did not appear to contribute to the pathogenesis of the EGR-like lesions, based on the clinical course of the disease. It is notable that an association between MF and lung cancer has been reported in 2 large cohorts of patients (8, 9).

REFERENCES