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Multiple Plaques on the Hands and Feet—Diagnosis
Arch Dermatol. 2007;143(1):109-114.
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Diagnosis: Mycosis fungoides (MF) palmaris et plantaris (MFPP).
MICROSCOPIC FINDINGS AND CLINICAL COURSE
The biopsy specimen from the hand showed a superficial and deep, perivascular and periadnexal infiltrate of mononuclear cells and focal dermal fibrosis. Many of the mononuclear cells displayed large nucleoli with cerebriform contours. Immunohistochemical stains showed that most of the cells expressed CD3, with a predominance of CD4 over CD8 cells. These findings supported the diagnosis of MF. Based on the number of large cells (more than 25% of the infiltrate), the patient was considered to have large-cell transformation.
The swollen left toe, which was found to be superinfected with enterococci and flavobacteria, was treated successfully with 1 course of moxifloxacin. Over the next 2 years, the patient underwent chemotherapy (3 rounds of gemcitabine followed by 3 rounds of doxorubicin) and then topical nitrogen mustard therapy, which he is still receiving. He has also received bexarotene for the last 7 months. At his last follow-up, the total body surface area . . . [Full Text of this Article] DISCUSSION
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Arch Dermatol. 2007;143(1):109-114.
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