Mycosis fungoides differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2], Sowminya Arikapudi, M.B,B.S. [3]


Cutaneous T cell lymphoma must be differentiated from other diseases such as eczema and psoriasis.

Differentiating Cutaneous T cell lymphoma from other Diseases

Disease Rash Characteristics Signs and Symptoms Associated Conditions Rash Appearance
Cutaneous T cell lymphoma/Mycosis fungoides[8]
Pityriasis rosea[9]
  • Pink or salmon in colour, which may be scaly, termed as "herald patch"
  • Oval in shape
  • Long axis oriented along the clevage lines
  • Distributed on the trunk and proximal extremities
  • Squamous marginal collarette and a “fir-tree” or “Christmas tree” distribution on the posterior trunk
  • Develops after viral infection
  • Resolves spontaneously after 6-8 weeks
Pityriasis lichenoides chronica
  • Recurrent lesions are usually less evenly scattered than psoriasis
  • Brownish red or orange-brown color
  • Lesions are capped by a single detachable opaque mica-like scale
  • Often leave hypopigmented macules
Nummular dermatitis[12]
  • Lesions commonly relapse after occasional remission or may persist for long periods
  • Pruritis
Secondary syphilis[13]
Bowen’s disease[14]
  • Erythematous little scaly plaque, which enlarges over time in an erratic manner
  • Scale is usually yellow or white and it is easily detachable without producing any bleeding
  • Well defined margins
Exanthematous pustulosis[16]
Hypertrophic lichen planus[18]
Sneddon–Wilkinson disease[20]
  • Flaccid pustules that are often generalized and have a tendency to involve the flexural areas
  • Have an annular configuration
Small plaque parapsoriasis[24]
  • Lesions may be asymptomatic
  • May be mildly pruritic
  • May fade or disappear after sun exposure during the summer season, but typically recur during the winter
Langerhans cell histiocytosis[27]
  • Scaling and crusting of the scalp
Tinea manuum/pedum/capitis[31]
Seborrheic dermatitis [32][33]


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