Predictive Value of Dermoscopic Examination of Early Stage Mycosis Fungoides

Abstract

Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma (CTCL) accounting for almost 50% of all primary cutaneous lymphoma .Early diagnosis of MF remains of crucial interest in clinical practice. In early stages, clinical and histopathological diagnosis of MF is difficult and may be indistinguishable from chronic dermatitis in a high proportion of patients. Dermoscopy, is a noninvasive diagnostic technique for the in vivo observation of skin lesions. Their use has gained great popularity for aiding the diagnosis of pigmented skin lesions Later on, the use of dermoscopes has been applied for the diagnosis of non-pigmented skin lesions including, hair diseases, skin tumors and inflammatory dermatoses.It is regarded as an intermediate step between clinical examination and dermatopathology. To evaluate the predictive value of dermoscopy in differentiating early stage MF (I & IIa) from chronic eczema and to establish the dermoscopic features of early stage MF (40) patients with chronic eczematous patches clinically suggestive of mycosis fungoides were examined dermoscopically. According to our findings, lesion of chronic dermatitis exhibited dermoscopic pattern which differed from that observed in MF. MF showed a dermoscopic pattern combining of fine short linear blood vessels (95%), orange yellow patch area (70%), dotted blood vessels (70%), spermatozoa like structure (45%) and white scales (70%). On the other hand, chronic dermatitis showed dermoscopic pattern combining of dotted blood vessels (70%), yellow scales (35%) and white scales (80%). Our results show that the dermoscopic pattern of MF and eczema are different. Fine short linear blood vessels, orange yellow patch area and spermatozoa like structure represent the most frequent specific pattern in MF. None of these finding were observed in chronic dermatitis which represent the most common differential diagnosis. Identification of the above mentioned criteria in adematis case should raise the suspicion of MF and should indicate the need for histopathological and immunohistochemical examination.