Early mycosis fungoides: Integrating clinical, histopathological and molecular insights to improve diagnosis and risk stratification.

Mycosis fungoides (MF) remains a diagnostic challenge in its early stages, due to its ability to mimic common inflammatory dermatoses and the subtlety of its histopathological features. This review integrates recent advances in anatomical pathology and molecular research, highlighting how the combined assessment of morphology, immunophenotype, clonality studies and emerging high-throughput platforms is reshaping our understanding of the disease. Transcriptomic analyses, microRNA profiling and spatial technologies reveal distinctive signatures of early-stage MF, along with microenvironmental and immune alterations that precede clinically evident progression. These findings not only enhance diagnostic accuracy but also help identify patients at higher risk of disease progression. Overall, the integration of clinical, histopathological, and molecular data is defining a new paradigm for refined prognostic stratification and precision-medicine approaches in cutaneous T-cell lymphomas.