Dermoscopy of Mycosis Fungoides

This was a multicenter cross-sectional study conducted in three Tertiary Referral Dermatology Departments in Tunisia (Charles Nicolle Hospital, La Rabta Hospital, and Habib Thameur Hospital) between January 2021 to December 2021. It involved 89 patients with phototype III-V and early-stage MF, PP, or CD. Only patients with confirmed diagnosis of early-stage MF (Ia, Ib, IIa) based on histopathological and immunohistochemical features were considered for inclusion. Patients under 18 and those with exclusive involvement of the scalp, soles, palms, nails, elbows, or knees were excluded, as well as cases of generalized pustular psoriasis, erythrodermic psoriasis, guttate psoriasis, and psoriatic arthritis without cutaneous involvement.
Dermoscopic analysis
For all included patients, up to 3 representative cutaneous lesions were selected and examined using dermoscopy (DermLite DL4©, 3GEN, US). Both clinical and dermoscopic photos were recorded for each selected lesion. Dermoscopic photos were interpreted by two independent evaluators (AC and NL). Any discrepancy was resolved by consensus.
Consensual dermoscopic terminology by the International Dermoscopic Society was used (6) (7). Descriptive terminology was preferably adopted. Based on this consensual terminology, vascular structures were described as dots, clods, linear, coiled, looped, serpentine, helical, curved, monomorphous, or polymorphous vessels. These vessels could be arranged in nine patterns: radial, serpiginous, branched, centered dots, uniform, clustered, peripheral, reticular, and nonspecific. Scales were described in four distinct patterns: diffuse, central, peripheral, or patchy. Follicular features consisted of follicular plugs, follicular red dots, perifollicular white coloration, and perifollicular pigmentation. A few metaphorical terms were employed when intuitive descriptive equivalents are lacking. This includes spermatozoa vessels, linearly arranged scales, spicules, short hairs, and coiled hairs.
Statistical analysis
All data were electronically compiled and analyzed using IBM SPSS version 19.T-test and Chi-square were respectively employed for comparison of continuous or parametric variables and Fisher's exact bilateral test was employed in case of invalidity of the Chi-square test. P-value of less than 0.05 was considered significant.