Dermoscopy of stage llA mycosis fungoides

Abstract

OBJECTIVE: Differential diagnosis of mycosis fungoides (MF) in the early stages can be challenging. Dermoscopy has beenreported to be useful in the evaluation of early MF. However, to our knowledge, there is no study that specifies these earlystages as stage IA, IB or IIA. The present study aims to evaluate the dermoscopic findings of stage IIA MF in comparisonwith plaque psoriasis (PP).METHODS: Thirty-four patients aged between 16-70 years with stage IIA MF (n=17) and PP (n=17) were evaluated in thisprospective study. Dermoscopic examinations were performed by manual dermatoscopy (Dermlite DL4). χ2 test was used.RESULTS: In patients with stage IIA MF, orange-yellow patches (88.2%), short, fine and linear vessels (82.3%), geometric white scales (70.5%), perifollicular white scales (47%) and white patches (35.2%) were common, while dotted vessels(94.1%), diffuse lamellar white scales (88.2%) and dotted and globular vessels (70.5%) were common in patients with PP.Although spermatozoa-like structures, purpuric dots, collarette white scales and Y-shaped arborizing vessels were commonin patients with MF, this was not statistically significant. Geometric white scales (clinically; cigarette paper-like wrinkly scales)correlated with alternating parakeratosis and orthokeratosis in the stratum corneum histopathologically.CONCLUSION: A unique aspect of our study is that this study provides insights about the importance of scales in differentiating MF from PP. Orange-yellow and white patches, short, fine and linear vessels, geometric and perifollicular white scalesmay be useful in distinguishing stage IIA MF from PP by hand-held dermoscopy.