case_images: PMC11750483_01
case_images: A, Clinical photograph of mycosis fungoides of the face in the form of infiltrative scaly patches showing well-defined "notched edges" (=notch sign; white arrows) associated to secondary alopecia. Misdiagnosis is very common in early cutaneous T-cell lymphoma. Therefore, the presence of the notch sign in association with other clinical diagnostic signs of mycosis fungoides is an important additional help to guide the clinician. B, Histological findings of the patches showed follicular invasion by atypical CD3+ T cells associated to follicular mucinosis.
case_images: gr1.jpg
case_images: PMC11750483_01_gr1.jpg
case_images: fig1
case_images: On examination, the clinical review of systems was normal with exception of infiltrative scaly patches with well-defined "notched edges" observed on the upper body and head (Fig 1, A). Skin biopsies were performed and histopathological findings confirmed the diagnosis of CTCL in the form of folliculotropic MF (Fig 1, B).
case_images: Progression of cutaneous T-cell lymphoma to tumor stage with characteristic leonine facies after failure of several lines of treatment.
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case_images: PMC11750483_01_gr2.jpg
case_images: fig2
case_images: Over time, the skin lesions thickened to become copper-colored tumors, giving rise to the characteristic leonine facies (Fig 2).