早期普发型硬皮病在临床上可以模仿真菌性丰富病变症。早期炎症性硬皮病的显微镜特征可能显示不同程度的浸润，且没有典型的皮肤胶原硬化。我们报告了一例63岁女性患者的病例，她有2个月的无症状皮肤疹史。体格检查显示躯干和大腿上有多发的红斑到暗斑，类似于真菌性丰富病变的斑块期。进行了两次皮肤活检，均显示网状真皮中具有突出的间质淋巴细胞浸润，但没有真皮硬化。在表皮中，局部观察到小淋巴细胞外渗和沿真皮-表皮交界处排列。血管周围区域观察到小团簇的浆细胞和嗜酸性粒细胞。尽管CD4和CD8染色没有发现明显的优势克隆性，但免疫组化研究显示CD5抗原丢失50％，CD7抗原表达丢失90％。随后的血液检查显示正常血细胞计数和阳性人类T淋巴病毒1型抗体。整体发现暗示间质真菌性丰富病变或早期成人T细胞淋巴瘤-白血病。患者拒绝积极治疗，3个月后，她出现了原先皮疹部位的硬化斑块。复查活检显示典型的硬皮病特征。本报告讨论了早期普发性炎性硬皮病临床和组织病理诊断的注意事项，临床医生和病理学家都应该考虑这些注意事项。© 2023 John Wiley & Sons A/S. 版权所有，John Wiley & Sons Ltd. 发表。

Early generalized morphea can clinically mimic mycosis fungoides. The microscopic features of early inflammatory morphea may show variable degrees of infiltration and do not have the characteristic dermal collagen sclerosis. We report the case of a 63-year-old female patient who presented with a 2-month history of an asymptomatic skin rash. Physical examination revealed multiple erythematous to dusky patches on the trunk and thighs, resembling the patch stage of mycosis fungoides. Two skin biopsies were performed, both of which showed prominent interstitial lymphoid infiltration in the reticular dermis without dermal sclerosis. Small lymphocyte exocytosis and lining along the dermal-epidermal junction were observed focally in the epidermis. Small clusters of plasma cells and eosinophils were observed in perivascular areas. Although no predominant clonality was found for CD4 and CD8 stains, 50% loss of CD5 antigen and 90% loss of CD7 antigen expression were apparent in immunohistochemical studies. Subsequent blood tests showed a normal blood cell count and positive human T-lymphotropic virus Type 1 antibodies. The overall findings suggested interstitial mycosis fungoides or early adult T-cell lymphoma-leukemia. The patient refused aggressive treatment, and 3 months later, she presented with indurated plaques from the previous rash. A repeat biopsy revealed the typical features of morphea. This report discussed the pitfalls in the clinical and histopathological diagnosis of early generalized inflammatory morphea that both clinicians and pathologists should consider.© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.