Mycosis Fungoïdes in an Old Patient: A Diagnostic Challenge
Roua Mankai,
Fatma Daoud,
Imene Rachdi,
Fatma Khanchel,
Mehdi Somai,
Hana Zoubeidi,
Besma Ben Dhaou,
Zohra Aydi,
Aschraf Chadli Debbiche,
Anissa Zaouak,
Fatma Boussema
Issue:
Volume 5, Issue 2, December 2022
Pages:
11-14
Received:
17 March 2022
Accepted:
11 June 2022
Published:
29 September 2022
DOI:
10.11648/j.ijcd.20220502.11
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Abstract: Mycosis Fongoïde is a rare T cell lymphoma. The mean age of onset is about sixty year old, mostly in masculin population. The clinical presentation is dominated by cutaneous signs. We report the case of a 78 year old patient, with a history of erythroderma with pruritus non ameliorated by corticosteroid topics, who was readmitted four years later for osteomyelopathy. At physical examination, he had bilateral axillary lymph nodes. We also noted dry generalized erythroderma with no interval of healthy skin and at the neurologic exam, there was ataxia on walking and a bilateral pyramidal syndrome majorated on the right. The blood count showed hyperleukocytosis with hyperlymphocytosis and chronic hypereosinophilia. The blood smear showed Sezary cells of the order of 2000. The CT scan has confirmed the presence of axillary adenopathies, left breast nodules not found on breast ultrasound, and bilateral adenomegaly of the external iliac and inguinal chains. The first cutaneous biopsy was not conclusive. Axillary node biopsy, 6th skin biopsy and Immunophenotyping of circulating CD4+ T lymphoctes allowed to retain Mycosis fungoides. He was treated with Methotrexate for a year with improvement. Mycosis Fungoides is a rare disease with diagnostic and therapeutic difficulties due to the non contribution of confirmatory examinations wich may delay the diagnostic and with a possibility of atypical presentation.
Abstract: Mycosis Fongoïde is a rare T cell lymphoma. The mean age of onset is about sixty year old, mostly in masculin population. The clinical presentation is dominated by cutaneous signs. We report the case of a 78 year old patient, with a history of erythroderma with pruritus non ameliorated by corticosteroid topics, who was readmitted four years later f...
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