Normal-looking skin in patients with mycosis fungoides may show histopathological, electron microscopical, immuno-phenotypical and/or molecular genetic evidence of neoplastic lymphocytes [106-108]. These cases have been termed 'invisible' mycosis fungoides in the literature, because the lesions are clinically inapparent. The presence of such histological features in normal-looking skin has been documented at the first diagnosis of mycosis fungoides, in patients with mycosis fungoides at sites distant from erythematous lesions and in patients in complete clinical remission after treatment [106-108].
The finding of specific infiltrates of mycosis fungoides in skin that looks clinically normal poses two main questions: the first relates to the extent of the area treated by skin-targeted therapies, and the second concerns the proper monitoring of patients after treatment.
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