Dermoscopy and reflectance confocal microscopy features of hypopigmented mycosis fungoides in children

Abstract

Objective To investigate dermoscopy and reflectance confocal microscopy (RCM) features of hypopigmented mycosis fungoides (HMF) in children, and to evaluate the consistency in diagnosis of HMF between histopathological examination and the combination of dermoscopy with RCM. Methods A total of 15 outpatients with suspected HMF who visited the Department of Dermatology were enrolled into this study from November 2014 to October 2015, and their dermoscopy and RCM images were collected. All the patients underwent histopathological, immunohistochemical and other related examinations. Results Based on dermoscopy and RCM images, 15 cases were suspected to be HMF, and 13 cases were confirmed to be HMF. Dermoscopy images of HMF showed obvious skin lines, white scurf-like scales, reticular, zebra-like or dotted depigmentation, and blood vessels distributed in punctiform, short linear, spermatozoa-like or stellate patterns. RCM images of HMF showed many highly refractive cells in each layer of the epidermis and dermal-epidermal junction, Pautrier's microabscess in some regions, and dermal papillary rings with decreased refractivity which were surrounded by many highly refractive cells in the basal layer. Conclusion HMF has characteristic dermoscopy and RCM images, so dermoscopy and RCM can serve as useful methods for early screening and auxiliary diagnosis of HMF in children. Key words: Mycosis fungoides; Dermoscopy; Microscopy, confocal; Depigmentation