(Last Updated On: April 2, 2019)

Authors: Nenita Q. Manzano, MD, FPDS, Jo Faustine Manzano, MD, Johannes F. Dayrit, MD, FPDS


Mycosis fungoides (MF) is an epidermotropic, primary cutaneous T-cell lymphoma (CTCL) composed of small to medium-sized T-lymphocytes with cerebriform nuclei and with a T-helper phenotype.1 This is the most common type of cutaneous lymphoma, which represents almost 50% of all lymphomas arising in the skin.1-3 The incidence of MF is approximately 0.36 per 100,000 person-years in the United States.4-5
Pigmented purpuric dermatosis (PPD) is a general term that is used to describe a group of chronic and relapsing cutaneous lesions of unknown etiology. This is characterized by petechiae and pigmentary macules of the lower limbs.6, 7 Mycosis fungoides may present in various forms as
there are atypical variants that have been described in literature, one of the rare forms is the pigmented-purpura like MF.8 Mycosis fungoides clinically presenting as PPD was also described in a renal transplant patient.



Manzano NQ, Manzano J, Dayrit J. Pigmented purpuric dermatosis (PPD)-like mycosis fungoides on the leg of a Filipino male. J Phil dermatol Soc. 2018; 27(2):99-100.



Mycosis fungoides, epidermotropic, T-cell lymphoma

1. Cerroni L. Mycosis fungoides. In: Cerroni L. Skin lymphomas. Wiley-Blackwell, Oxford, 2014:11-73. doi: 10.1002/9781118492505.ch2.
2. Willemze R, Jaffe ES, Burg G, et al. WHO-EORTC classification for cutaneous lymphomas. Blood. 2005;105(10):3768-3785. doi: 10.1182/blood-2004-09-3502.
3. Cerroni L, Sander CA, Smoller BR, et al. Mycosis fungoides. In: Swerdlow SH, Campo E, Harris NL, et al., eds. WHO classification of tumours of haematopoietic and lymphoid tissues. Revised 4th edition. IARC, Lyon Cedex, 2017:385-389
4. Weinstock MA, Gardstein B. Twenty-year trends in the reported incidence of mycosis fungoides and associated mortality. Am J Public Health 1999;89:1240-4.
5. Weinstock MA, Horn JW. Mycosis in the United States. Increasing incidence and descriptive epidemiology. JAMA 1988;260:42-6.
6. Kim DH, Seo SH, Ahn HH, Kye YC, Choi JE. Characteristics and Clinical Manifestations of Pigmented Purpuric Dermatosis. Annals of Dermatology. 2015;27(4):404-410. doi:10.5021/ad.2015.27.4.404.
7. Gönül M, Külcü Çakmak S, Özcan N, Oğuz ID, Gül Ü, Bıyıklı Z. Clinical and Laboratory Findings of Pigmented Purpuric Dermatoses. Annals of Dermatology. 2014;26(5):610-614. doi:10.5021/ad.2014.26.5.610.
8. Al-Abdulrazzaq A, Zadeh VB, Al-Otaibi S, Najem N. Purpuric mycosis fungoides : A rare presentation of a great masquerader. The Gulf Journal of Dermatology and Venereology. 2011. 18(2): 47-49
9. Borges da Costa J, Soares-Almeida L, Guerra J: Mycosis fungoides presenting as a pigmented purpuric dermatosis in a renal transplanted patient. Journal of Organ transplantation. 2017; 1(1):1-4
10. Goldenberg G. Cutaneous T-cell lymphoma: Focus on mycosis fungoides. Available from: http://www.medscape.com/ viewarticle/529351. [Last accessed on 2007 Feb 17].
11. Cerroni L. Mycosis fungoides-clinical and histopathologic features, differential diagnosis, and treatment. Semin Cutan Med Surg. 2018 Mar;37(1):2-10. doi: 10.12788/j.sder.2018.002.
12. Magro CM, Schaefer JT, Crowson AN, Li J, Morrison C. Pigmented purpuric dermatosis: classification by phenotypic and molecular profiles. Am J Clin Pathol. 2007;128:218–229. 13. Sardana K, Sarkar R, Sehgal VN. Pigmented purpuric dermatoses: an overview. Int J Dermatol. 2004;43:482–488.
14. Panda S. Mycosis fungoides: Current trends in diagnosis and management. Indian J Dermatol 2007:52(1):5-20
15. Hanna S, Walsh N, & D’Intino Y, Langley R. Mycosis Fungoides Presenting as Pigmented Purpuric Dermatitis. Pediatric Dermatology.2006, 23. 350 – 354. 10.1111/j.1525-1470.2006.00259.
16. Zackheim H, Kashani-Sabet M, McMillan A. Low dose methotrexate to treat mycosis fungoides: a retrospective study in 69 patients. J Am Acad Dermatol, 49 (5) ,873-878.
17. Olek-Hrab K, Maj J, Chmielowska E, Jankowska-Konsur A, Olszewska B, Kręcisz B, Iwankowski P, Mackiewicz-Wysocka M, Adamski Z, Nowicki R, SokolowskaWojdylo M. Methotrexate in the treatment of mycosis fungoides – a multicenter

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