Hyperpigmented Mycosis Fungoides: A Rare Variant with Diagnostic Challenges

Abstract

Hyperpigmented mycosis fungoides (MF) is a rare variant of cutaneous T-cell lymphoma, often misdiagnosed due to its resemblance to inflammatory dermatoses. We report a 77-year-old lady with a 12-year history of pruritic, hyperpigmented rashes initially misdiagnosed as chronic eczema. Diagnosis was confirmed after multiple biopsies, leading to treatment with methotrexate and PUVA therapy, resulting in remission. This case highlights the challenges in diagnosing atypical MF variants, emphasizing the need for early clinico-pathological correlation. Increased awareness of hyperpigmented MF can aid in reducing diagnostic delays and improving patient outcomes.

Key words: Mycosis Fungoides,  Cutaneous T-Cell Lymphoma, Hyperpigmentation, Skin Neoplasms