How are patches and plaques characterized in cutaneous T-cell lymphoma (CTCL)?

Updated: Aug 15, 2018
  • Author: Lauren C Pinter-Brown, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The patch stage of mycosis fungoides is characterized by usually erythematous macules that may have a fine scale, may be single or multiple, and may be pruritic (see the image below). In dark-skinned individuals, the patches may appear as hypopigmented or hyperpigmented areas. As the patches become infiltrative, they evolve into palpable plaques.

Patch-stage mycosis fungoides. Patch-stage mycosis fungoides.

The plaques tend to be raised, demonstrating fine-scale, well-demarcated, erythematous shapes with irregular borders. Annular or serpiginous patterns with central clearing and pruritus are common. (See the images below.)

Plaque-stage mycosis fungoides. Plaque-stage mycosis fungoides.
Partially confluent, erythematous plaques in advan Partially confluent, erythematous plaques in advancing mycosis fungoides.
Close-up view of advancing plaque-stage mycosis fu Close-up view of advancing plaque-stage mycosis fungoides with partially confluent, erythematous plaques.

Patches and plaques may affect any area of the skin, but they are often distributed asymmetrically in the sun-protected areas that a bathing suit would cover (ie, hips, buttocks, groin, lower trunk, axillae, breasts). When mycosis fungoides affects the scalp, it is often accompanied by alopecia.


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