SKIN BIOPSY RESULTS

Please tell me what is your opinion about this skin biopsy report:

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CLINICAL HISTORY:
Well defined eczematous patch - upper back x 18/12. Clinically tinea but no response.
Tro mycosis/fungoides

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TISSUES
Skin biopsy.

GROSS DESCRIPTION
Specimen labeled - Soft tissue
The specimen consists of a piece of skin tissue measuring 3 mm. Submitted entirely into 1 block.

MICROSCOPIC DESCRIPTION
The skin shows parakeratosis, and a psoriasiform hyperplasia. There is marked acanthosis, and suprabasal thinning, associated with telangiectasia of the dermal capillaries. A mild lymphocytic infiltrate is noted at the dermoepidermal junction, around upper dermal vessels and within the epidermis. These lymphocytes apear histologically benign. Focal keratinocyte necrosis is noted. Polymorphs and intraepidermal microabscesses are not seen. Organisms are not seen.

DIAGNOSIS
Lesion from upper back
Psoriasiform hyperplasia with lymphocytic infiltrate.

Comment:
The differentials include psoriasis and early mycosis. Immunohistochemical studies may be useful to exclude the latter.

(END OF REPORT)
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My problem is that just 10 days after the biopsy, my skin was completely normal and it was healed -without use of any medicine-. All I did was stop scratching the area.

Now it's been 3 months after the biopsy and as I said above, my skin is completely normal.
What should I do?  Honestly, I don't trust my doctor. He says that he doesn't know exactly what it is, and he doesn't answer my questions, but he keeps giving me medicine (pills and creams and antibiotics lately).
Should I change my doctor??

[Hystaspes]

?

[Bhupinder Kaur, MD]

Hello,
From the biopsy report two differentials are coming up: psoriasis and mycosis. Psoriasis is a long-term (chronic) skin problem that causes skin cells to grow too quickly, resulting in thick, white, silvery, or red patches of skin. Mycosis is fungal infection of the skin. Since the patch healed after biopsy and you are taking treatment, so it looks like a mycosis or fungal infection as psoriasis does not heal so quickly.

I hope it helps. Take care and regards.

[silvercloud]

I am not a health professional, but I do have mycosis fungoides, so I know a bit about it. Sorry to contradict the above MD but MF is NOT a fungal infection and has nothing to do with fungi (except for the visual appearance of the symptoms.) MF is a cancer, a kind of lymphoma (as seen from the lymphocytic infiltrate in your biopsy). Consult a doctor immediately. In it's first stages MF can be treated by simply getting a good suntan 2-3 times a week, either naturally of artificially. You've got to keep this condition in check!

[maatson]

Now look at the difference, mycosis(Fungal -singular) Mycoses(Fungal -plural), Mycosis fungoides(Cutaneous lymphoma) . Only hoped histopathologist had made it clearer!

[maatson]

However Silvercloud is right in pointing out.