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Microscopic study of normal skin in cases of mycosis fungoides
Author(s) -
ElDarouti Mohammad A.,
Marzouk Salonaz A.,
Bosseila Manal,
Zeid Ola Abu,
ElSafouri Omar,
Zayed Amira,
ElRamly Amany,
AbdelHalim Mona R. E.
Publication year - 2006
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4632.2006.02686.x
Subject(s) - mycosis fungoides , medicine , biopsy , skin biopsy , pathology , lesion , punch biopsy , dermatology , lymphoma
Background During therapy of patients with mycosis fungoides (MF) at the Department of Dermatology, Kasr El‐Aini Hospital, follow‐up biopsies are routinely taken every 2 months. It was noticed that lesions of MF might become clinically normal during treatment, and yet still show microscopical evidence of MF. This finding raised the possibility that clinically normal skin in MF could be microscopically involved. Aim The aim of our work was to evaluate the degree of histopathological involvement of normal‐looking skin in patients with MF. Patients and methods Thirty patients with stage IB were biopsied from their normal skin. Two biopsies were taken: one proximal (2 cm) and the other distal (> 5 cm) from any visible lesion. Ten normal controls were included in the study. All specimens were stained with H&E and examined microscopically. The microscopical diagnosis was confirmed by immunophenotyping. Results Epidermotropism was detected in 21 (70%) of the proximal skin biopsies and 14 (47%) of the distal skin biopsies, whereas no biopsy from the control group showed epidermotropism. All the proximal skin biopsies showed dermal infiltrate and 90% of the biopsies from the distal normal skin showed dermal infiltrate (mostly superficial perivascular). Conclusion Normal skin in patients with MF could be affected microscopically and this may raise questions regarding the credibility of the current staging classification of MF, and may necessitate taking biopsies from normal skin before starting topical treatment. During MF treatment, biopsies from cured lesions are required before starting withdrawal.