Dermatoscopic Characteristics, Lesional Capillaroscopic Features, and Histopathological Correlation of Small Plaque Parapsoriasis and Mycosis Fungoides
Keywords:
dermoscopy, dermoscopic patterns, capillaroscopy, mycosis fungoides, parapsoriasisAbstract
Introduction: Dermatoscopy is a frequently used non-invasive diagnostic procedure.
Objectives: Considering that mycosis fungoides (MF) mimics parapsoriasis clinically in early stages, we aim to determine the dermatoscopic criteria and the histopathological correlations in patients with MF and small plaque parapsoriasis (SPP).
Methods: This prospective study involved 28 patients with clinical and histopathological diagnoses of MF and 31 patients with SPP. Videodermoscopy and USB capillaroscope were used to evaluate the patients vessels at ×200 magnification. Vascularity was evaluated through microvascular density (MVD) scoring involving CD34 antibody staining.
Results: Fifty-nine patients were included in this study. The scores corresponding to the presence of short linear vessels, linear-curved vessels, branching linear vessels, and non- structured orange-colored areas were significantly higher in the MF patients than in the SPP patients (P < 0.05). The highest MVD (P = 0.01) scores were also higher in the MF patients than in the SPP patients.
Conclusions: The SPP and early-stage MF patients differed in their MVD scores, and the findings correlated with the dermatoscopy and lesional capillaroscopy findings. Differentiating features between SPP and MF were thus identified.
References
Amorim GM, Niemeyer-Corbellini JP, Quintella DC, Cuzzi T, Ramos-E-Silva M. Clinical and epidemiological profile of patients with early stage mycosis fungoides. An Bras Dermatol. 2018;93(4):546-552. DOI: 10.1590/abd1806-4841.20187106. PMID: 30066762. PMCID: PMC6063099.
Jawed SI, Myskowski PL, Horwitz S, Moskowitz A, Querfeld C. Primary cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome): part II. Prognosis, management, and future directions. J Am Acad Dermatol. 2014;70(2):223.e1-e17; DOI: 10.1016/j.jaad.2013.08.033. PMID: 24438970.
Errichetti E, Lallas A, Apalla Z, Stinco G. Dermoscopy of chronic superficial scaly dermatitis (small-plaque parapsoriasis): a controlled comparative morphological study. Int J Dermatol. 2021;60(3):e94-e96. DOI: 10.1111/ijd.15214. E. PMID: 33040330.
Bordignon M, Belloni-Fortina A, Pigozzi B, Saponeri A, Alaibac M. The role of immunohistochemical analysis in the diagnosis of parapsoriasis. Acta Histochem. 2011;113(2):92-95. DOI: 10.1016/j.acthis.2009.12.006. PMID: 20083298.
Errichetti E, Zalaudek I, Kittler H, et al. Standardization of dermoscopic terminology and basic dermoscopic parameters to evaluate in general dermatology (non-neoplastic dermatoses): an expert consensus on behalf of the International Dermoscopy Society. Br J Dermatol. 2020;182(2):454-467. DOI: 10.1111/bjd.18125. PMID: 31077336.
Willemze R. Primary cutaneous lymphoma: the 2018 update of the WHO-EORTC classification. Presse Med. 2022;51(1):104126. DOI: 10.1016/j.lpm.2022.104126. PMID: 35569698.
Hodak E, Amitay-Laish I. Mycosis fungoides: A great imitator. Clin Dermatol. 2019;37(3):255-267. DOI: 10.1016/j.clindermatol.2019.01.004. PMID: 31178107.
Ryu HJ, Kim SI, Jang HO, et al. Evaluation of the International Society for Cutaneous Lymphoma Algorithm for the Diagnosis of Early Mycosis Fungoides. Cells. 2021;10(10):2758. DOI: 10.3390/cells10102758. PMID: 34685738. PMCID: PMC8534563.
Song SX, Willemze R, Swerdlow SH, Kinney MC, Said JW. Mycosis fungoides: report of the 2011 Society for Hematopathology/European Association for Haematopathology workshop. Am J Clin Pathol. 2013;139(4):466-490. DOI: 10.1309/AJCPOBDP2OQAJ5BR. PMID: 23525617.
Kim YH, Liu HL, Mraz-Gernhard S, Varghese A, Hoppe RT. Long-term outcome of 525 patients with mycosis fungoides and Sezary syndrome: clinical prognostic factors and risk for disease progression. Arch Dermatol. 2003;139(7):857-866. DOI: 10.1001/archderm.139.7.857. PMID: 12873880.
van Santen S, Jansen PM, Quint KD, Vermeer MH, Willemze R. Plaque stage folliculotropic mycosis fungoides: histopathologic features and prognostic factors in a series of 40 patients. J Cutan Pathol. 2020;47(3):241-250. DOI: 10.1111/cup.13615. PMID: 31755567. PMCID: PMC7028105.
van Doorn R, Scheffer E, Willemze R. Follicular mycosis fungoides, a distinct disease entity with or without associated follicular mucinosis: a clinicopathologic and follow-up study of 51 patients. Arch Dermatol. 2002;138(2):191-198. DOI: 10.1001/archderm.138.2.191. PMID: 11843638.
Skov AG, Gniadecki R. Delay in the histopathologic diagnosis of mycosis fungoides. Acta Derm Venereol. 2015;95(4):472-475. DOI: 10.2340/00015555-1971. PMID: 25228392.
Bombonato C, Pampena R, Lallas A, Giovanni P, Longo C. Dermoscopy of Lymphomas and Pseudolymphomas. Dermatol Clin. 2018;36(4):377-388. DOI: 10.1016/j.det.2018.05.005. PMID: 30201147.
Lallas A, Apalla Z, Lefaki I, et al. Dermoscopy of early stage mycosis fungoides. J Eur Acad Dermatol Venereol. 2013;27(5):617-621. DOI: 10.1111/j.1468-3083.2012.04499.x. PMID: 22404051.
Xu C, Liu J, Wang T, Luo Y, Liu Y. Dermoscopic patterns of early-stage mycosis fungoides in a Chinese population. Clin Exp Dermatol. 2019;44(2):169-175. DOI: 10.1111/ced.13680. PMID: 29876963.
Errichetti E, Apalla Z, Geller S, et al. Dermoscopic spectrum of mycosis fungoides: a retrospective observational study by the International Dermoscopy Society. J Eur Acad Dermatol Venereol. 2022;36(7):1045-1053. DOI: 10.1111/jdv.18078. PMID: 35285088. PMCID: PMC10239555.
Errichetti E, Geller S, Zalaudek I, et al. Dermatoscopy of nodular/plaque-type primary cutaneous T- and B-cell lymphomas: A retrospective comparative study with pseudolymphomas and tumoral/inflammatory mimickers by the International Dermoscopy Society. J Am Acad Dermatol. 2022;86(4):774-781. DOI: 10.1016/j.jaad.2021.10.020. PMID: 34695527.
Saito S, Kuriyama Y, Uchiyama A, Yasuda M, Motegi SI. Capillaroscopy in Pigmented Basal Cell Carcinoma Smaller than 3-mm Diameter: A Report of Four Lesions. Acta Derm Venereol. 2022;102:adv00762. DOI: 10.2340/actadv.v102.2522. PMID: 36000995. PMCID: PMC9593473.
Newell B, Bedlow AJ, Cliff S, Drysdale SB, Stanton AW, Mortimer PS. Comparison of the microvasculature of basal cell carcinoma and actinic keratosis using intravital microscopy and immunohistochemistry. Br J Dermatol. 2003;149(1):105-110. DOI: 10.1046/j.1365-2133.2003.05325.x. PMID: 12890202.
Rosina P, Giovannini A, Gisondi P, Girolomoni G. Microcirculatory modifications of psoriatic lesions during topical therapy. Skin Res Technol. 2009;15(2):135-138. DOI: 10.1111/j.1600-0846.2008.00336.x. PMID: 19622121.
Stinco G, Buligan C, Maione V, Valent F, Patrone P. Videocapillaroscopic findings in the microcirculation of the psoriatic plaque during etanercept therapy. Clin Exp Dermatol. 2013;38(6):633-637. DOI: 10.1111/ced.12036. PMID: 23763515.23. Stinco G, Lautieri S, Piccirillo F, Valent F, Patrone P. Response of cutaneous microcirculation to treatment with mometasone furoate in patients with psoriasis. Clin Exp Dermatol. 2009;34(8):915-919. DOI: 10.1111/j.1365-2230.2009.03298.x. PMID: 19486040.
Caresana G, Giardini R. Dermoscopy-guided surgery in basal cell carcinoma. J Eur Acad Dermatol Venereol. 2010;24(12):1395-1399. DOI: 10.1111/j.1468-3083.2010.03652.x. PMID: 20384678.
Hack SP, Zhu AX, Wang Y. Augmenting Anticancer Immunity Through Combined Targeting of Angiogenic and PD-1/PD-L1 Pathways: Challenges and Opportunities. Front Immunol. 2020;11:598877. DOI: 10.3389/fimmu.2020.598877. PMID: 33250900. PMCID: PMC7674951.
Ramjiawan RR, Griffioen AW, Duda DG. Anti-angiogenesis for cancer revisited: Is there a role for combinations with immunotherapy? Angiogenesis. 2017;20(2):185-204. DOI: 10.1007/s10456-017-9552-y. PMID: 28361267. PMCID: PMC5439974.
Wu J, Ma S, Sun L, et al. Prognostic Value of Microvessel Density in Non-Hodgkin Lymphoma: A Meta-Analysis. Acta Haematol. 2021;144(6):603-612. DOI: 10.1159/000515211. PMID: 34044389.
Tamma R, Ingravallo G, Annese T, et al. Tumor Microenvironment and Microvascular Density in Follicular Lymphoma. J Clin Med. 2022;11(5):1257. DOI: 10.3390/jcm11051257. PMID: 35268349. PMCID: PMC8911525.
Bosseila M, Sayed Sayed K, El-Din Sayed SS, Abd El Monaem NA. Evaluation of Angiogenesis in Early Mycosis Fungoides Patients: Dermoscopic and Immunohistochemical Study. Dermatology. 2015;231(1):82-86. DOI: 10.1159/000382124. PMID: 26044542.
Zohdy M, Abd El Hafez A, Abd Allah MYY, Bessar H, Refat S. Ki67 and CD31 Differential Expression in Cutaneous T-Cell Lymphoma and Its Mimickers: Association with Clinicopathological Criteria and Disease Advancement. Clin Cosmet Investig Dermatol. 2020;13:431-442. DOI: 10.2147/CCID.S256269. PMID: 32606882. PMCID: PMC7320895.
Vandergriff T, Nezafati KA, Susa J, et al. Defining early mycosis fungoides: validation of a diagnostic algorithm proposed by the International Society for Cutaneous Lymphomas. J Cutan Pathol. 2015;42(5):318-328. DOI: 10.1111/cup.12470. PMID: 25721994.
Väkevä L, Sarna S, Vaalasti A, Pukkala E, Kariniemi AL, Ranki A. A retrospective study of the probability of the evolution of parapsoriasis en plaques into mycosis fungoides. Acta Derm Venereol. 2005;85(4):318-323. DOI: 10.1080/00015550510030087. PMID: 16191852.
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