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Background: Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma (CTCL). Differentiation of MF especially early stages (eMF) from its benign mimickers is important to ensure proper management. TOX is a critical regulator of early T-cell development in the thymus that is considered as a useful marker for MF diagnosis and prognosis. Objective: The aim of the current study is to evaluate the ability of molecular marker TOX protein in diagnosis of eMF, and its ability to differentiate eMF from similar benign inflammatory skin diseases (BIDs). Materials and Methods: This is a case control study, and was carried out on 60 subjects; 20 patients as eMF, 20 patients as (BIDs) and 20 normal skin specimens as control cases. The diagnosis was established after clinicopathological correlation. Immunohistochemistry (IHC) was done for MF, BIDs and normal skin cases for TOX and CD4 IHC stains. Results: TOX expression showed a significant positive expression in MF cases compared to BIDs and control groups, with 100% sensitivity and 95% specificity. The pattern of TOX IHC stain in MF was diffuse, while in BIDs was focal. There was positive correlation between TOX and CD4 staining in MF cases. Conclusion: TOX might be considered a diagnostic marker for eMF that can differentiate eMF from BIDs mimickers.

Evaluation of the molecular marker TOX protein in diagnosis of early stages of mycosis fungoides.