Dermatoscopic Patterns in Mycosis Fungoides: Observations from a Case-series Retrospective Analysis and a Review of the Literature

Background: Dermoscopy, a non-invasive diagnostic tool, is increasingly used to evaluate cutaneous T-cell lymphomas such as Mycosis Fungoides (MF) and Sézary Syndrome (SS). However, its diagnostic accuracy and role in staging remain underexplored. Objective: This study aimed to assess dermoscopic patterns in MF and SS, correlating findings with disease stages and lesion types to evaluate diagnostic utility. Methods: A retrospective, monocentric analysis was conducted on patients with histologically confirmed MF or SS. Dermoscopic images were evaluated for vascular patterns, pigmentation, scaling, and keratin plugs. Statistical analysis assessed correlations with TNMB staging and lesion types. Results: All lesions were pigment-free, with vascular patterns being the predominant dermoscopic feature. Linear vessels (40%) and serpentine vessels (13.3%) were most common. Scaling, observed in 76.7% of lesions, showed diffuse or perifollicular distribution. No statistically significant correlations were found between dermoscopic features, TNMB stages, or lesion types. Cluster analysis suggested variability but no definitive patterns for disease staging. Conclusion: Dermoscopy reveals consistent vascular patterns but lacks sensitivity for staging MF and SS. More significant prospective studies with standardised descriptors are needed to refine its diagnostic and staging utility. Histopathological confirmation remains essential for accurate diagnosis.