A case of typical mycosis fungoides in an HIV-positive patient

Abstract

Non-Hodgkin’s lymphomas in HIV patients are generally B-cell lymphomas. The coexistence of HIV-1 infection with Cutaneous T-Cell Lymphoma (CTCL) is an infrequent occurrence, particularly in the classic variety of Mycosis Fungoides (MF). This case demonstrates that in an HIV-1 positive patient, CTCL can manifest as MF with features comparable to those reported in the general population. We report a 52-year-old male patient with asymptomatic HIV-1 who presented with the eruption of pruritic papules with overlying grey scales over his torso and extremities for two years. In a biopsy specimen, small intraepidermal lymphocytes without significant atypia were detected. Immunohistochemistry confirmed the diagnosis of T-cell lymphoma. The disease had spread to lymph nodes throughout the body. This is one of the few cases in which a typical MF is described in an HIV-1 patient. MF can be difficult to identify owing to its slow progression and resemblance to other inflammatory conditions such as spongiotic dermatitis. While MF is a very uncommon sign in HIV-infected individuals, it should be included in the differential diagnosis of all patients presenting with relevant cutaneous manifestations.