Mycosis Fungoides – Causes, Symptoms, Diagnosis and Treatment - By: Peter Hutch

Mycosis Fungoides, is a rare form of non-Hodgkin's lymphoma characterized by patches, plaques, and tumors. It is also known as cutaneous T cell lymphoma (CTLC), which affects the skin. Lymphomas are blood tumors. In mycosis fungoides the blood lymphoma stays mostly in the skin. This results in a rash. Most people who have mycosis fungoides will have the rash over many years. It is very difficult to determine if someone has mycosis fungoides, usually several biopsies are required over a number of years before the diagnosis can be made. This infection is confined to the skin and it rarely affects other parts of the body. These changes develop slowly over the years.

Who Can Get Them?

African American individuals are more likely to get mycosis fungoides than Caucasian individuals. The rashes will appear very light or very dark on those with a darker skin tone. Males are affect more so by this ailment than women. Individuals over the age of fifty are more likely to get the condition. The most common age is forty-five to fifty-five years for those who develop the rash and plaque. The tumors and lesions will start to develop after an individual turns sixty.

Causes and Symptoms of Mycosis Fungoides

1. Mycosis Fungoides has outward visible symptoms.
2. They appear as rash like patches, plaques or lesions.
3. The duration of the aliment from its onset to diagnosis can be up to six years.

Tumors: tumors can originate from plaques, red skin, or normal skin. They are usually reddish brown or purple. The itching can diminish, but the tumors may develop painful open sores or become infected. Some tumors can become very large. Patches, plaques, and tumors can co-exist.

Erythrodermic form: in the erythrodermic form, the skin becomes red, thickened, and sometimes peels and flakes. The palms and soles thicken and may crack. Itching is usually intense. More than 90% of the time, the erythrodermic form is associated with Sézary syndrome.
Other, more rare symptoms are also seen, including itching alone.

Diagnosis

Typically there is about 6 years from the time symptoms begin to the diagnosis of mycosis fungoides. Confusion with other conditions is common. A sample of the skin can be taken (skin biopsy) and examined for the disease. Other laboratory tests can be done to determine the progression of the cancer.

Treatment

Chemotherapy is employed primarily for patients with advanced MF; systemic treatment with chemotherapeutic agents (cyclophosphamide, methotrexate, doxorubicin, bleomycin, etoposide, and steroids) and interferon-alfa produces transient regression.

Common treatments include simple sunlight, ultraviolet light, topical steroids, topical and systemic chemotherapies, local superficial radiotherapy, total skin electron beam radiation, and biological therapies (e.g. interferons, retinoids, rexinoids).Vorinostat (Zolinza®) is a second-line drug for CTCL. Application of organic (Manuka) honey to skin affected by erythorderma (red skin) has also proved to be effective in reducing inflammation. Treatments are often used in combination.

PUVA is a combination treatment. You will take psoralen (P) pills two hours before exposing your skin to long wave ultra violet light (UVA). Usually PUVA treatment will be given twice a week until your skin is clear, and then less often. Some patients respond well to single weekly treatments. A bath solution of psoralen can be used instead of the tablets, but this is mainly used for psoriasis - your treatment may therefore seem to be different from that of the other patients having PUVA for other skin conditions.

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