Mycosis fungoides, the most common form of cutaneous T-cell lymphoma, may present atypically in African skin as hypopigmented patches or plaques rather than the classic erythematous lesions seen in lighter skin. These hypopigmented areas, often misdiagnosed as vitiligo or tinea, typically appear on the trunk or buttocks and may be itchy. Diagnosis requires a high index of suspicion and confirmatory skin biopsy with immunohistochemistry. Treatment includes topical steroids, phototherapy (NB-UVB or PUVA), and systemic therapies in advanced stages.