You May Not Have Seen 'It', But 'It' Has Seen You: Commonly Missed Diagnoses in Onco-Dermatology

The presentation discusses the challenges of diagnosing cutaneous T-cell lymphoma (CTCL) in patients with skin conditions, particularly within the context of onco-dermatology. By presenting a series of 19 clinical cases, the speaker emphasizes diagnostic pitfalls and the overlap between dermatological symptoms and cancer treatment effects. Key points include the difficulty of recognizing erythroderma, especially in patients with skin of color, and the misleading nature of biopsy results that might reflect non-specific dermatitis. The discussion highlights the need for thorough evaluations, considering both clinical history and advanced diagnostic tests like flow cytometry and T-cell receptor sequencing. Several patients with persistently itchy skin and flaring conditions were ultimately diagnosed with CTCL or Cesare syndrome after extensive roundabouts in treatment and misdiagnoses. The importance of reevaluating clinical suspicions over time and the risks associated with treatments such as dupilumab in undiagnosed CTCL patients are also noted. Overall, the cases illustrate the need for careful scrutiny in dermatology, particularly regarding potential underlying malignancies that can be easily overlooked.