Abstract
The diagnosis of cutaneous T-cell lymphomas (CTCL) is frequently delayed by a median of three years and requires the clinical evaluation of an experienced dermatologist and a confirmatory skin biopsy. Dermoscopy and high-frequency ultrasound (HFUS) represent two non-invasive diagnostic tools. While dermoscopy is inexpensive and widely used for the diagnosis of melanoma and non-melanoma skin cancers, HFUS of skin lymphomas represents a novel diagnostic approach that is not yet implemented in the routine dermatologic practice. The aim of our study was to prospectively assess skin lesions of patients with either CTCL patches or plaques with dermoscopy and HFUS and to compare the findings with atopic dermatitis (AD) and psoriasis. Thirteen patients with an established diagnosis of CTCL, psoriasis, or AD were studied: Dermoscopy features including spermatozoa-like structures and the presence of white scales could assist in differentiating between early-stage CTCL and AD. HFUS measurements of the skin thickness indicated increased epidermal-, thickness in CTCL, and psoriasis compared with AD. Our results support the use of dermoscopy as a useful tool to diagnose CTCL. HFUS could augment the dermatologic assessment, but further studies will be needed to define standardized parameters.
Highlights
Cutaneous T-cell lymphomas (CTCL) represent a heterogeneous group of Non-Hodgkin lymphomas that are characterized by neoplastic T lymphocytes infiltrating the skin
The diagnosis of CTCL is frequently delayed by three years [6]
Diagnosis is currently based on the clinical assessment and histopathologic evaluation of experienced dermatologists and pathologists [16]
Summary
Cutaneous T-cell lymphomas (CTCL) represent a heterogeneous group of Non-Hodgkin lymphomas that are characterized by neoplastic T lymphocytes infiltrating the skin. Primary CTCL show no evidence of extra-cutaneous manifestation at diagnosis, with Mycosis fungoides (MF). MF is characterized by the presence of red scaly patches or plaques, predominantly on sun-protected areas of the body [3]. Patients may develop thick infiltrated plaques, tumours, or leukemic disease with lymph node and visceral involvement [3,4]. MF has been described as one of the great dermatological imitators [5], requiring experienced clinicians and a sophisticated interplay between clinical evaluation, histopathology, and molecular biology to establish the correct diagnosis [6]. Scale Own Cases CTCL-Plaque Ghahramani Cases et al [13].
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