Case 79

Medical history

A 75 year-old male patient reports the presence of scaling lesions in his scalp, trunk and arms from childhood and the appearance 10 years ago of erythematous infiltrated scaly plaques which have since disseminated. He also shows some tumoral lesions throughout his body and complains of mild itching. On examination, he presents with lymph nodes slightly enlarged in the right axilla and a liver palpable 3 cm below the right costal margin. Abdominal computed tomography displayed modest hepatomegaly with no other alterations. He underwent a skin biopsy which revealed a severe infiltrate of atypical lymphoid cells with hyperchromatic nuclei and scant cytoplasm in the dermis and epidermis (epidermotropism).

Based on the clinical data and images provided, which is the most likely diagnosis?

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