Clinical Analysis of Granuloma Fungoides Misdiagnosed as Psoriasis Vulgaris

WU Mingming; XIAO Jing; PAN Cuicui; SHEN Xiaoyan; ZHAO Xiaoqing; ZHENG Jie

doi:10.3969/j.issn.1002-3429.2024.12.002

Abstract：Objective To investigate the clinical characteristics,the cause of misdiagnosis,and the preventive mea-sures of granuloma fungoides as psoriasis.Methods The clinical data of 1 patient with granuloma fungoides misdiagnosed 40 years ago were retrospectively analyzed,and the relevant literature was reviewed.Results The patient presented with ery-thematous scaly of the whole body for 40 years,and red papule of the trunk with pruritus for 4 years.Forty years ago,a rash appeared on both lower limbs,which gradually increased to plaque.The long-term diagnosis was psoriasis,and the treatment was poor.Four years ago,miliary papules with pruritus appeared on the trunk,which was considered granuloma fungoides by pathologic examination in another hospital.Later,due to repeated rashes,psoriasis vulgaris was again diagnosed by pathologic examination at different sites,and the symptomatic treatment was poor.After admission,the relevant examination was per-formed,and the diagnosis was confirmed:granuloma fungoides(stage Ⅳ B).The treatment plan was adjusted,and the condi-tion was stable.Conclusion Early clinical and pathological manifestations of granuloma fungoides are not typical,and it is prone to misdiagnosis.For patients with atypical or unresponsive psoriasis,especially before initiation of immunosuppressant therapy,histopathological and other specific tests are recommended to confirm the diagnosis and rule out granuloma fungoi-des,so as to reduce misdiagnosis and improve patient prognosis.