A patient with stereotypical mycosis fungoides associated with hypopigmentation


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View Figure  		Figs. 55 & 56  Hypopigmented patches of different sizes and shapes, some of them with peculiar geometric outlines
 
A 46-year-old woman with dark skin presented herself with asymptomatic hypopigmented macules and patches on the trunk, buttocks, and groin. She claimed that the condition had been progressing, slowly but steadily, for 10 years. Physical examination of those sites revealed zones of hypopigmentation accompanied by slight erythema and fine scales. A biopsy was performed of a typical lesion on the back.

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View Figure  		Fig. 57 & 58  Mycosis fungoides, macular/patch stage. Note lymphocytes disposed as solitary units aligned in the basal layer and the paucity of spongiosis in conjunction with lymphocytes in the spinous zone.
 
The changes histopathologically are those of mycosis fungoides, namely, a superficial perivascular and patchy lichenoid infiltrate of lymphocytes, those round cells also being aligned as solitary units in loci in the epidermal basal layer and in the spinous zone, nuclei of lymphocytes being somewhat pleomorphic and larger than ones in the dermis, and thickened bundles of collagen being arrayed haphazardly in the upper part of the dermis.