Mycosis Fungoides in Elderly Adults: A Diagnostic Challenge

April 2014 in “ Journal of the American Geriatrics Society ”

William Ngan, Johnny C. Y. Chan, Gloria Yu-yan Hwang, James Ka-Hay Luk

scalp itchiness hair loss psoriasis mycosis fungoides skin lymphoma alemtuzumab chemotherapy

TLDR Diagnosing mycosis fungoides, a rare skin cancer, is difficult in elderly adults and requires careful examination to avoid mistaking it for less serious skin conditions.

A 73-year-old Chinese woman experienced over 10 years of scalp itchiness, redness, and hair loss, initially misdiagnosed as psoriasis. Her condition worsened, developing a breast nodule and erythematous patches. Biopsies eventually confirmed mycosis fungoides (MF), a rare skin lymphoma. Despite initial improvement with alemtuzumab, she relapsed and responded well to chemotherapy. This case highlighted the diagnostic challenges of MF, especially in elderly adults, and underscored the importance of thorough examination and high clinical suspicion for serious conditions. The prognosis for MF is poorer in older adults and advanced stages, necessitating systemic therapy.

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