Abstract
A 51-year-old woman presented to the ED for severe, intractable pain due to ulcerated skin lesions. She reported an initial presentation of patches and thin plaques, and an earlier biopsy was interpreted as consistent with early mycosis fungoides(MF). Within the past year, widespread ulcerations developed. On exam, there were confluent ulcers with necrosis, surrounded by erythematous patches distributed across the chest, back, axillae, breasts, and lower extremities. Given the clinical evolution of ulceronecrotic lesions from thin patches and plaques, cytotoxic T cell lymphoma(CTCLs), including primary cutaneous aggressive epidermotropic cytotoxic T cell lymphoma(PC-AECTCL), γδ lymphoma, and NK-like lymphoma were considered.
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