Mycosis fungoides is the most common subset of cutaneous T-cell lymphoma. We discuss a rare case of advanced mycosis fungoides that presented as a dramatic tumoral stage lymphoma. Early lesions can often mimic other dermatologic conditions and while the patient was unable to provide a history on early lesions initial diagnosis and mis-treatment for psoriasis may have contributed to a late presentation. In attempting to confirm our suspected diagnosis multiple biopsies and immunohistochemical analysis were required to reach a verdict. This paper emphasizes the importance of compiling a comprehensive picture and the need for persistence when there is inconclusive evidence to establish a diagnosis of mycosis fungoides.
