Case Number : Case 1865 - 21 July - Dr Iskander Chaudhry (Invited) Posted By: Guest

Very nice case of PagetoidReticulosis/Worringer/Kolopp variant of MF.  Solitary lesion on arm: clinically fit well  

Would like also to point to the possibility of the variant of LPLK that mimics MF. 

Pagetoid reticulosis, melanoma,LPLK

One of the clinical hypotheses is actinic keratosis, so the lesion is likely to be a papule. Lymphomatoid papulosis type D is my spot.

Agree with most of the differentials, the clinical picture will be the ultimate judge in this particular case. Nevertheless, I had the impression that this is pagetoid reticulosis as Vincenzo mentioned.

Agree with pagetoid reticulosis, if this is solitary. Although LyP type D cant be distinguished histologically, it would be odd for LyP to present as a solitary leison.

Pagetoid reticulosis

Favor Pagetoid reticulosis over LPLK (MF like).

My first thought is LPLK  based on clinicopathological correlation

Dear All - Many thanks for your comments. The infiltrate was mixed T and B cells.

Our final diagnosis was:

Lymphomatoid Keratosis. 

A case of lymphomatoid keratosis. Choi MJ, Kim HS, Kim HO, Song KY, Park YM. Ann Dermatol. 2010 May;22(2):219-22.

The final report stated:

I do not believe this is cutaneous lymphoma. However, if the patient develops lesions that are clinically concerning for mycosis fungoides, those should be biopsied; or if this lesion returns, there should be a low threshold for re-biopsy.

To date there has been no recurrence or development of additional lesions. 

Acknowledgement to Dr Uma Sundrum who I consulted on this case.