Patient with pruritic lesion over Left shoulder showing cigarette paper atrophy and poikiloderma with generalized lymphadenopathy. Histopathology exmanination of lesion shows CD4 positive sezary leutzner cells. What is the dermo-epidermal manifestation of this disease?
In mycosis fungoides is the commonest type of cutaneous T cell lymphoma. In the patch stage cigarette paper atrophy and poikiloderma are seen . There is lymphedenopathy and sezary cells ( abnormal lymphocytes with large convoluted nuclei ) circulating in blood. Histopathology shows collection of atypical lymphocytes( Pautriers micro abscesses ) in epidermis and band of lymphoid cells ( some atypical with convoluted nuclei) in the upper dermis. From illustrated synopsis of dermatology and sexually transmitted diseases neena khanna 5th edition page no 405, 406
Pautrier's micro abscess
Pin point ulcers
Discharging sinus
Miliaria
Skin tumors