Hyperpigmentation as a peculiar presentation of mycosis fungoides

Hyperpigmented mycosis fungoides is an extremely rare subtype of mycosis fungoides. it presents as multiple pigmented macules and patches without poikilodermatous changes and characterized by a cd8+ phenotype on immunohistochemistry. this report describes a typical case of hyperpigmented mycosis fungoides in a 62-year-old woman,who presented with a 7-year history of multiple hyperpigmented macules and patches on the trunk and right leg with progression over this half a year. histology and immunohistochemical staining of skin samples confirmed the diagnosis of mycosis fungoides. she received psoralen plus ultraviolet a (puva) therapy. after an 8-week treatment,the erythematous changes cleared without recurrence during a 6-month follow-up period. an intractable hyperpigmented patch should raise the clinical suspicion of mycosis fungoides with sequential skin biopsy. © 2017 by anais brasileiros de dermatologia.