Lichen sclerosus mimicking mycosis fungoides preceding B-cell lymphoma – diagnostic challenges

Agnieszka Oszywa; Andrzej K. Jaworek; Grzegorz Dyduch; Agnieszka Giza; Anna Wojas-Pelc

doi:10.5114/dr.2021.108611

eISSN: 2084-9893
ISSN: 0033-2526

Dermatology Review/Przegląd Dermatologiczny

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3/2021
vol. 108

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abstract:

Case report

Lichen sclerosus mimicking mycosis fungoides preceding B-cell lymphoma – diagnostic challenges

Agnieszka Oszywa

¹

,

Andrzej K. Jaworek

²

,

Grzegorz Dyduch

³

,

Agnieszka Giza

⁴

,

Anna Wojas-Pelc

¹

Department of Dermatology, The University Hospital, Krakow, Poland
Department of Dermatology, Jagiellonian University Collegium Medicum, Krakow, Poland
Department of Pathomorphology, Jagiellonian University Collegium Medicum, Krakow, Poland
Department of Hematology, Jagiellonian University Collegium Medicum, Krakow, Poland

Dermatol Rev/Przegl Dermatol 2021, 108, 202–212

DOI: https://doi.org/10.5114/dr.2021.108611

Online publish date: 2021/08/26

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Introduction
The diagnosis of cutaneous lymphomas is extremely difficult because of their morphological diversity and clinical similarity to many dermatoses.

Objective
Presentation of the case of a 70-year-old woman diagnosed with lichen sclerosus in whom the evolution of skin lesions raised suspicions of lymphocytic hyperplasia.

Case report
The patient diagnosed with lichen sclerosus was hospitalized three times due to exacerbation of skin lesions with accompanying mycosis fungoides-mimicking infiltration. Cutaneous lymphoma was excluded in biopsy specimens collected from skin lesions. In the following months, a new nodular lesion appeared on the patient’s face that turned out to be marginal zone lymphoma. After increasing the dose of methotrexate to 20 mg/week, a rapid remission of skin lesions was achieved.

Conclusions
The presented case shows that the diagnosis of primary cutaneous lymphoma is a significant challenge in everyday dermatological practice and requires repeated biopsy.

keywords:

Lichen sclerosus mimicking mycosis fungoides preceding B-cell lymphoma – diagnostic challenges

Agnieszka Oszywa 1 , Andrzej K. Jaworek 2 , Grzegorz Dyduch 3 , Agnieszka Giza 4 , Anna Wojas-Pelc 1

lichen sclerosus, mycosis fungoides, marginal zone lymphoma

Agnieszka Oszywa

¹

,

Andrzej K. Jaworek

²

,

Grzegorz Dyduch

³

,

Agnieszka Giza

⁴

,

Anna Wojas-Pelc

¹