Late diagnosis of mycosis fungoides: a case report

Abstract

INTRODUCTION: Mycosis fungoides (MF) is a cutaneous T-cell lymphoma with an incidence of approximately 0.41/100,000
individuals annually. This report highlights the impacts of delayed diagnosis on the evolution of the disease. CASE REPORT:
A female patient sought medical assistance at the dermatology service of the Universidade do Estado do Pará (UEPA), Brazil,
on November 2017, due to three infiltrated erythematous-hyperchromic plaques, two on the abdomen and one scaly on
the left lower limb, and a palpable lymph node in the left inguinal region with progressive growth which started in 2011.
The patient reported that she had undergone several tests and treatments and was seen by six medical doctors of different
specialties and underwent four histopathological exams. The patient's case was investigated in the dermatology service of
UEPA; an immunohistochemical study was performed, concluding the diagnosis of MF. She was treated with methotrexate
15 mg and folic acid 5 mg in a single weekly dose and phototherapy with PUVA, showing significant improvement after
treatment, but with an extensive area of atrophy and secondary infections. CONCLUSION: The present case is a public
health issue that reinforces the need for adequate medical training for early identification and treatment of MF.