Histopathologic Comparisons of Discoid Lupus Erythematosus and Folliculotropic Mycosis Fungoides in a Series of 43 Cases.

IF 1.6 4区 医学 Q3 DERMATOLOGY Journal of Cutaneous Pathology Pub Date : 2024-11-06 DOI:10.1111/cup.14752
Camilla A Cascardo, Meghan R Mansour, Sandra Oska, Uma Sundram
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Abstract

Background: Folliculotropic mycosis fungoides (FMF) is a rare cutaneous malignancy that can be mistaken for inflammatory diseases, such as discoid lupus erythematosus (DLE), due to the variability of histopathological findings.

Methods: This study aims to provide dermatopathologists with evidence-based histopathologic criteria to distinguish DLE from FMF by reporting overlapping and distinguishing microscopic features. Forty-three biopsies from patients with a confirmed diagnosis of DLE or FMF were graded for the presence or absence of 18 histopathologic features.

Results: The main histopathologic findings present in nearly all DLE and FMF biopsies were folliculocentric and folliculotropic patterns. Comedones, granulomas, and folliculitis were not prominent. Follicular hyperplasia, follicular plugging, interstitial mucin, lichenoid/interface dermatitis, and plasma cells were significantly more common in DLE biopsies, while follicular mucinosis and eosinophils were significantly more common in FMF samples. Cytologic atypia ranged from none to mild in DLE and mild to moderate in FMF. Rarely, both sets of biopsies contained epidermotropism, spongiosis, or peri-eccrine infiltration.

Conclusion: While many histopathological features present in DLE overlap with features found in FMF, such as folliculocentrism and folliculotropism, significant differences do exist. Therefore, when diagnosing FMF, it is important to follow established criteria that differentiate this malignancy from inflammatory conditions such as DLE.

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43 例系列病例中盘状红斑狼疮与毛囊性真菌病的组织病理学比较。
背景:毛囊真菌病(FMF)是一种罕见的皮肤恶性肿瘤,由于组织病理结果的多变性,可能被误认为是盘状红斑狼疮(DLE)等炎症性疾病:本研究旨在为皮肤病理学家提供循证组织病理学标准,通过报告重叠和可区分的显微特征来区分DLE和FMF。研究人员对确诊为DLE或FMF患者的43份活检组织病理样本进行了分级,以确定是否存在18种组织病理特征:结果:几乎所有DLE和FMF活检组织病理学发现的主要病理特征都是滤泡中心型和滤泡向心性。粉刺、肉芽肿和毛囊炎并不突出。在DLE活检样本中,毛囊增生、毛囊堵塞、间质粘蛋白、苔癣样皮炎/界面皮炎和浆细胞明显更常见,而在FMF样本中,毛囊粘蛋白病和嗜酸性粒细胞明显更常见。DLE样本的细胞学不典型性从无到轻度不等,FMF样本的细胞学不典型性从轻度到中度不等。两组活检样本中均罕见表皮增生、海绵状增生或肾周浸润:结论:尽管DLE的许多组织病理学特征与FMF的特征重叠,如毛囊中心性和毛囊向心性,但两者仍存在显著差异。因此,在诊断 FMF 时,必须遵循既定的标准,将这种恶性肿瘤与 DLE 等炎症性疾病区分开来。
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来源期刊
CiteScore
3.20
自引率
5.90%
发文量
174
审稿时长
3-8 weeks
期刊介绍: Journal of Cutaneous Pathology publishes manuscripts broadly relevant to diseases of the skin and mucosae, with the aims of advancing scientific knowledge regarding dermatopathology and enhancing the communication between clinical practitioners and research scientists. Original scientific manuscripts on diagnostic and experimental cutaneous pathology are especially desirable. Timely, pertinent review articles also will be given high priority. Manuscripts based on light, fluorescence, and electron microscopy, histochemistry, immunology, molecular biology, and genetics, as well as allied sciences, are all welcome, provided their principal focus is on cutaneous pathology. Publication time will be kept as short as possible, ensuring that articles will be quickly available to all interested in this speciality.
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