Diagnosis of early mycosis fungoides

Criteria	Scoring system
Clinical
Basic	2 points for basic criteria and two additional criteria
Persistent and/or progressive patches/thin plaques	1 point for basic criteria and one additional criterion
Additional:
1. Non-sun-exposed location
2. Size/shape variation
3. Poikiloderma
Histopathologic
Basic	2 points for basic criteria and two additional criteria
Superficial lymphoid infiltrate	1 point for basic criteria and one additional criterion
Additional:
1. Epidermotropism without spongiosis
2. Lymphoid atypia^*
Molecular biologic
1. Clonal T cell receptor gene rearrangement	1 point for clonality
Immunopathologic
1. <50% CD2+, CD3+, and/or CD5+ T cells	1 point for one or more criteria
2. <10% CD7+ T cells
3. Epidermal/dermal discordance of CD2, CD3, CD5, or CD7^¶

A total of 4 points is required for the diagnosis of mycosis fungoides based on any combination of points from the clinical, histopathologic, molecular biologic, and immunopathologic criteria.

* Lymphoid atypia is defined as cells with enlarged hyperchromatic nuclei and irregular or cerebriform nuclear contours.
¶ T cell antigen deficiency confined to the epidermis.

Graphic 74457 Version 4.0

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Diagnosis of early mycosis fungoides