To the Editor.—
The article by Eng et al in the June 1981 Archives (117:332-337) illustrates the need for improved criteria for evaluating the skin biopsy specimens from patients suspected of having mycosis fungoides (MF). The conclusion of Eng et al that there are "no significant differences between the size or shape of cells of benign cases and the cases of mycosis fungoides" is contrary to the common experience that the recognition of a pleomorphic lymphoid infiltrate in a characteristic distribution in the skin allows the diagnosis to be made by light microscopy in most cases of plaque and tumor stage MF. A greater diagnostic problem is in the early lesions of MF. Nine (75%) of 12 biopsy specimens shown in Table 1 of the article by Eng et al were from plaque and tumor stage MF, so one would expect greater differences than those found by Eng et al.
McNutt NS. Measuring Mycosis Fungoides. Arch Dermatol. 1982;118(4):214-215. doi:10.1001/archderm.1982.01650160004004