Background: Angiogenesis is the production of new blood vessels from an existing vascular network; it plays a critical role in solid tumor development and metastasis. Objectives: To assess angiogenesis in early cases of mycosis fungoides (MF) and to determine vascular patterns in MF dermoscopically. Methods: 25 patients with MF and 20 healthy controls were included. The MF lesions were assessed dermoscopically. CD34 immunohistochemistry was performed to count dermal microvessel density (MVD). Results: The total dermal MVD was significantly higher in MF patients (19.77 ± 5.81) than in controls (4.44 ± 3.16; p = 0.013). Among them, there were 10.8 ± 4.1 sprouts of endothelial buds (clusters of cells per field) in patients and 2.4 ± 2 in controls (p = 0.000). The dotted pattern of blood vessels was the most frequently encountered pattern in the MF lesions by dermoscopy. Conclusions: Our findings support that neoangiogenesis is significantly increased in early MF lesions and that the main dermoscopic feature of MF is dotted blood vessels.

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