Clinical Features

Between 8% and 55% of patients with CTCL undergo transformation (2,3). The interval between diagnosis of MF and transformation is about 1-2 years (3,4) but can be more than 5-10 years. Clinically, transformation is characterized by occurrence of large tumors, which often become ulcerated (Fig. 1). Those tumors evolve from infiltrated plaques, but can also arise on previously unaffected skin and at any time point in the course of the disease. Superinfection of ulcerated lesions with Staphylococcus aureus and Pseudomonas aeruginosa is very common. Together with extracutaneous spread, septicemia originating from infected tumors is the major cause of death in patients with advanced stages of MF and SS.

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