Dermoscopy of stage llA mycosis fungoides

OBJECTIVE: Differential diagnosis of mycosis fungoides (MF) in the early stages can be challenging. Dermoscopy has been reported to be useful in the evaluation of early MF. However, to our knowledge, there is no study that specifies these early stages as stage IA, IB or IIA. The present study aims to evaluate the dermoscopic findings of stage IIA MF in comparison with 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 this prospective 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 common in 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 scales may be useful in distinguishing stage IIA MF from PP by hand-held dermoscopy.

Evre IIA Mikozis Fungoides Dermoskopisi

GÝRÝÞ ve AMAÇ: Mikozis fungoidesin (MF) erken evrelerinde ayýrýcý taný zorlu olabilir. Bunun yanýnda, dermoskopinin erken evre MF tanýsýnda faydalý olduðu bildirilmiþtir. Ancak, bu erken evreleri, IA, IB veya IIA olarak özelleþtiren bir çalýþma mevcut deðildir. Bu çalýþmanýn amacý, evre IIA MF'nin dermoskopik bulgularýný tanýmlayarak, plak psoriyazis bulgularý (PP) ile karþýlaþtýrmaktýr.
YÖNTEM ve GEREÇLER: Bu prospektif çalýþmada, evre IIA MF (n = 17) ve PP (n = 17) olan 16-70 yaþlarý arasýndaki 32 hasta deðerlendirildi. Dermoskopik incelemeler manuel dermatoskopi (Dermlite DL4) ile yapýldý. Ki kare testi kullanýldý.
BULGULAR: Evre IIA MF olan hastalarda turuncu-sarý yamalar (% 88.2), kýsa, ince ve lineer damarlar (% 82.3), geometrik beyaz skuamlar (% 70.5), perifoliküler beyaz skuamlar (% 47) ve beyaz yamalar (% 35.2) sýk olarak izlenirken, PP hastalarýnda noktasal damarlar (% 94,1), lameller beyaz skuamlar (% 88,2) ve noktasal ve globüler damarlar (% 70,5) sýk olarak izlendi. Spermatozoa benzeri yapýlar, purpurik noktalar, yakacýk benzeri skuamlar ve Y-þekilli dallanan damarlar MF hastalarýnda sýk görülse de, bu sýklýk istatistiksel olarak anlamlý deðildi. Geometrik beyaz skuamlar (sigara kaðýdý fenomeni) histopatolojik olarak stratum korneumda deðiþen parakeratoz ve ortokeratoz ile korele idi.
TARTIÞMA ve SONUÇ: Çalýþmamýzýn benzersiz bir yönü, evre IIA MF'nin PP'den ayrýlmasýnda skuamlarýn önemi hakkýnda fikir vermesidir. Evre IIA MF'yi, PP'den ayýrmada dermatoskopide izlenen turuncu-sarý ve beyaz lekeler, kýsa, ince ve doðrusal damarlar, geometrik ve perifoliküler beyaz skuamlar yararlý olabilir. (NCI-2019-0161)