{
  "abstract": "Objectives Early-stage mycosis fungoides (MF) is diagnostically challenging due to overlap with inflammatory dermatoses. Age-related immunological and cutaneous changes may modify histopathological presentation. We aimed to compare clinical, histopathological and immunophenotypic features of early-stage MF between geriatric and non-geriatric patients.Design Multicentre retrospective cross-sectional study.Setting Dermatology departments of tertiary centres in Türkiye.Participants A total of 541 patients diagnosed with early-stage MF were included and stratified into geriatric (≥65 years) and non-geriatric (18–64 years) groups.Primary and secondary outcome measures The primary outcomes were age-related differences in histopathological and immunohistochemical features. Secondary outcomes included clinical characteristics and quality of life measures. Primary endpoints were prespecified a priori (epidermotropism, basilar lymphocytes, epidermal atrophy, dermal lymphocytic infiltration, papillary dermal fibrosis and CD4-dominant versus CD8(+)/CD4(−) phenotypes); all other comparisons were considered exploratory.Results The geriatric group had a higher proportion of males (59.5% vs 47.1%; p=0.004), while lesion type, duration, surface involvement and Dermatology Life Quality Index scores did not differ between groups. Histopathologically, epidermotropism (81.3% vs 63.3%), basilar lymphocytes (57.1% vs 45.7%), epidermal atrophy (26.6% vs 13.8%), dermal lymphocytic infiltration (75.8% vs 58.5%) and papillary dermal fibrosis (55.2% vs 38.4%) were more frequent in geriatric patients (all p<0.05). Plasma cells (13.5% vs 6.2%) and eosinophils (21.8% vs 13.8%) were also increased. A CD4-dominant phenotype was more common in geriatric patients (70.2% vs 60.6%; p=0.043), whereas a CD8-positive/CD4-negative phenotype was more frequent in non-geriatric patients (8.5% vs 2.6%; p=0.012). However, histopathological and immunohistochemical variables were extracted from existing routine pathology reports without central slide re-review, harmonised scoring criteria or adjudication; therefore, the reported frequencies may partly reflect intercentre/interobserver reporting practices and temporal changes in diagnostic work-up (eg, immunohistochemistry panels and reporting terminology) in addition to biological differences.Conclusions Although clinical characteristics were comparable across age groups, geriatric patients showed differences in reported histopathological and immunophenotypic features; these observations may facilitate clinicopathological recognition of early-stage MF in older individuals. However, some features (particularly epidermal atrophy and superficial/papillary fibrosis) are not MF-specific and may partly reflect background age- and site-related changes.",
  "authors": [
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Sakarya University, Sakarya, Turkey"
      ],
      "name": "Berna Solak"
    },
    {
      "affiliations": [
        "Department of Pathology, School of Medicine, Sakarya University, Sakarya, Turkey"
      ],
      "name": "Gözde Çakırsoy Çakar"
    },
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Sakarya University, Sakarya, Turkey"
      ],
      "name": "Zeynep Güngör"
    },
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Mersin University, Mersin, Turkey"
      ],
      "name": "Selen Gezmen"
    },
    {
      "affiliations": [
        "Department of Pathology, School of Medicine, Mersin University, Mersin, Turkey"
      ],
      "name": "Yasemin Yuyucu Karabulut"
    },
    {
      "affiliations": [
        "Department of Dermatology, University of Health Sciences, Ankara Bilkent City Hospital, Istanbul, Turkey"
      ],
      "name": "Duriye Deniz Demirseren"
    },
    {
      "affiliations": [
        "Department of Pathology, Ankara Bilkent City Hospital, Ankara, Turkey"
      ],
      "name": "Huban Sibel Orhun"
    },
    {
      "affiliations": [
        "Department of Dermatology, University of Health Sciences, Ankara Bilkent City Hospital, Istanbul, Turkey"
      ],
      "name": "Rüveyda Gönülal Bak"
    },
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Pamukkale University, Pamukkale, Denizli, Turkey"
      ],
      "name": "Ozge Sevil Karstarli Bakay"
    },
    {
      "affiliations": [
        "Department of Pathology, School of Medicine, Pamukkale University, Pamukkale, Denizli, Turkey"
      ],
      "name": "Erdem Çomut"
    },
    {
      "affiliations": [
        "Department of Dermatology, University of Health Sciences, Ankara Etlik City Hospital, Istanbul, Turkey"
      ],
      "name": "Gamze Taş Aygar"
    },
    {
      "affiliations": [
        "Department of Pathology, University of Health Sciences, Ankara Etlik City Hospital, Istanbul, Turkey"
      ],
      "name": "Aysun Gökce"
    },
    {
      "affiliations": [
        "Department of Dermatology, University of Health Sciences, Ankara Etlik City Hospital, Istanbul, Turkey"
      ],
      "name": "Filiz Canpolat"
    },
    {
      "affiliations": [
        "Department of Dermatology, Kartal Dr Lutfi Kirdar City Hospital, University of Health Sciences, Istanbul, Turkey"
      ],
      "name": "Filiz Cebeci Kahraman"
    },
    {
      "affiliations": [
        "Department of Pathology, Istanbul Medeniyet University, Istanbul Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey"
      ],
      "name": "Bengü Çobanoğlu"
    },
    {
      "affiliations": [
        "Department of Dermatology, Sultan 2. Abdulhamid Han Educational and Research Hospital, İstanbul, Turkey"
      ],
      "name": "Özge Akbulak"
    },
    {
      "affiliations": [
        "Department of Dermatology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey"
      ],
      "name": "Aslı Aksu"
    },
    {
      "affiliations": [
        "Department of Dermatology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey"
      ],
      "name": "Hazel Ezgi Kaya"
    },
    {
      "affiliations": [
        "Department of Pathology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, İstanbul, Turkey"
      ],
      "name": "Deniz Altınel"
    },
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Tekirdağ Namık Kemal Üniversitesi, Tekirdağ, Turkey"
      ],
      "name": "Özge Zorlu"
    },
    {
      "affiliations": [
        "Department of Pathology, School of Medicine, Tekirdağ Namık Kemal Üniversitesi, Tekirdağ, Turkey"
      ],
      "name": "Sevil Karabağ"
    },
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Bursa Uludag University, Nilüfer, Bursa, Turkey"
      ],
      "name": "Serkan Yazici"
    },
    {
      "affiliations": [
        "Department of Pathology, School of Medicine, Bursa Uludag University, Nilüfer, Bursa, Turkey"
      ],
      "name": "Saduman Balaban Adim"
    },
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Kocaeli University, Körfez, Kocaeli, Turkey"
      ],
      "name": "Abdullah Demirbaş"
    },
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Kocaeli University, Körfez, Kocaeli, Turkey"
      ],
      "name": "Dilek Bayramgurler"
    },
    {
      "affiliations": [
        "Department of Pathology, School of Medicine, Kocaeli University, Kocaeli, Turkey"
      ],
      "name": "Büşra Yaprak Bayrak"
    },
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Dicle University, Diyarbakır, Turkey"
      ],
      "name": "Mustafa Esen"
    },
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Dicle University, Diyarbakır, Turkey"
      ],
      "name": "Bilal Sula"
    },
    {
      "affiliations": [
        "Department of Pathology, School of Medicine, Dicle University, Diyarbakır, Turkey"
      ],
      "name": "İbrahim İbiloğlu"
    },
    {
      "affiliations": [
        "Department of Dermatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey"
      ],
      "name": "Dilay Baştuğ"
    },
    {
      "affiliations": [
        "Department of Pathology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey"
      ],
      "name": "Fatmagül Kuşku Çabuk"
    },
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Atlas University, Istanbul, Turkey"
      ],
      "name": "Nazlı Caf"
    },
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey"
      ],
      "name": "Selami Aykut Temiz"
    },
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey"
      ],
      "name": "Munise Daye"
    },
    {
      "affiliations": [
        "Department of Pathology, School of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey"
      ],
      "name": "Fahriye Kılınç"
    },
    {
      "affiliations": [
        "Department of Pathology, School of Medicine, Sakarya University, Sakarya, Turkey"
      ],
      "name": "Abdullah Çelik"
    },
    {
      "affiliations": [
        "Department of Dermatology, School of Medicine, Mersin University, Mersin, Turkey"
      ],
      "name": "Ümit Türsen"
    }
  ],
  "title": "Age-related histopathological and immunophenotypic variations in early-stage mycosis fungoides: a multicentre retrospective study in Türkiye",
  "uid": "0b3e30e1-6cc8-5db4-bf42-86c05e5a0f6a"
}