Background: Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma, often posing diagnostic challenges due to its resemblance to benign dermatoses, particularly drug-induced eruptions. Aims: This study aims to examine cases where drug-induced eruptions mimic MF and provide insights to improve diagnostic approaches. Methods and Results: A literature review following PRISMA guidelines was conducted using PubMed, Embase, and Scopus databases, focusing on case reports and series published after 1990 involving histologic mimics of MF. Data on demographics, clinical presentation, implicated drugs, histologic findings, and treatment outcomes were analyzed. From 46 articles rendered, a total of 25 were included in our study that yielded forty cases to analyze. The average age of patients was 56 years and 58% were males. Anticonvulsants were the most frequently implicated drugs (58%), followed by anti-arrhythmic medications (10%) and immunomodulators (8%). Other category medications made up 25% of reported cases. Clinical presentations varied, with hypersensitivity-like reactions being common in patients on anticonvulsants (59%) and immunomodulators (67%), while MF-like lesions were more frequent in other category medications (56%). Histologically, atypical lymphocytes and epidermotropism were common findings, particularly in patients on anticonvulsants. Immunohistochemical analysis revealed significant difference in CD markers and drug class ( P = 0.04). Discontinuation of the offending drug often led to clinical remission, with an average resolution time of 61 days. Conclusion: Diagnosing MF requires careful consideration of the full clinicopathologic picture, especially when drug-induced mimics are suspected. Histologic and immunohistochemical evaluations, such as positivity for both CD4 and CD8 T-cells in the lymphocytic infiltrate, can be giveaways to a drug-induced etiology. Repeat biopsies after drug cessation can be particularly valuable in distinguishing true MF from drug-induced pseudo-lymphomas. These findings highlight the importance of considering drug-induced etiologies in MF-like presentations to avoid unnecessary treatments and ensure appropriate patient management.