“This image is of a 55 year-old Hindu tobacco farmer with fungal growths all over his face and scalp. He was diagnosed with Mycosis Fungoides which is a blood cancer called Cutaneous T-cell lymphoma. The disease was first described by Alejandro Posadas who found that it was caused by the fungus Coccidioides which causes Coccidioidomycosis, aka Valley Fever and is often found in the U.S. Southwest.”

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Mycosis Fungoides: Tumour d’emblee

Patient had a history of severe itching episodes for past three years which were not relieved by antihistaminics. There was no history of any preceding skin lesions. There was history of episodes of fever, weight loss, anorexia, and nausea for the past 2 months. He was a chronic smoker for the past 35 years. On examination, multiple infiltrated plaques and nodules with few erosions and foul smelling superficial ulcers were present over face and scalp.

The infiltrated skin over forehead, nose and ear lobules and loss of eyebrows gave a leonine face appearance [Figures [Figures11 and and2].2]. Bilateral cervical, post auricular, axillary and inguinal lymphadenopathy was noted. The nodes were discrete, non-tender, mobile, and firm in consistency. Loss of hair was seen on scalp, eyebrow, and axillary region. Systemic examination was normal and there was no hepatosplenomegaly.



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