HISTOPATHOLOGIC FINDINGS IN THE CLINICALLY UNINVOLVED SKIN OF PATIENTS WITH MYCOSIS-FUNGOIDES

Several of the methods of treating plaque-stage mycosis fungoides (MF) advocate treatment of the whole skin, although relatively little info rmation exists on the histologic appearance of clinically uninvolved M F skin. Our study was performed to elucidate the histologic appearance of the clinically uninvolved skin of plaque-stage MF patients, Biopsi es were taken from the clinically uninvolved skin of 18 untreated pati ents with plaque-stage MF, 1 cm (near) and greater than or equal to 10 cm (far) from the MF plaques, and from 23 normal, healthy controls. E ight to 12 serial sections from each specimen were examined. The most common histologic finding, which was observed in six (33%) biopsies of near skin and four (22%) biopsies of far skin compared with only one (4%) biopsy of normal control (p = 0.02 and 0.1, respectively), consis ted of mononuclear-cell infiltrate around a blood vessel in the papill ary dermis, with extension of some of these cells into the overlying e pidermis. More diffuse and epidermotropic mononuclear cell infiltrates were seen in an additional three (17%) biopsies of near skin, whereas mild nonepidermotropic superficial perivascular or perifollicular mon onuclear cell infiltrates were observed in an additional four (17%) bi opsies of the normal controls, In conclusion, the most common histolog ic finding in our study, which was observed predominantly in the MF gr oup, might represent an earlier stage and clinically undetectable invo lvement of the normal-looking skin in MF patients.