Mycosis Fungoides


Mycosis Fungoides

Description, Causes and Risk Factors:

Alternative Names: Granuloma Fungoides.

A chronic progressive lymphoma arising in the skin that initially simulates eczema or other inflammatory dermatoses. In advanced cases, ulcerated tumors and infiltration of lymph nodes may occur. The disease often infects the skin, but it can spread to various other parts of the body including the blood and internal organs with varying degrees of severity. A large majority of the patients with mycosis fungoides will generally have to live with the disease for the rest of their lives as there are no real known cures. One can only attempt to treat the symptoms and to alleviate some of the complications that are associated with it.

The causes of mycosis fungoides is yet unknown. Genetic predisposition may play a role in some cases, and familial occurrence has been reported in a few instances. Association with long-term exposure to various allergens has also been advocated, as well as exposure to environmental agents and association with chronic skin disorders and viral infections. In some countries, mycosis fungoides-like disorders are clearly associated with viral infections (i.e., HTLV-I-associated adult T-cell lymphoma/leukaemia), but search for viral particles in patients with mycosis fungoides has been unsuccessful.

This disease is more common in males than in females and is seen in people over 20 years of age. The most common group of people affected by mycosis fungoides are those in their mid 40s and 50s and those who suffer from tumors, erythroderma or leukemia. These conditions are known to be most often paired with mycosis fungoides.

Mycosis fungoides is a rare disease. According to a survey, incidence was reported to be 0.36/105 person-years from 1973 to 1992 in the United States.

Symptoms:

B-symptoms present.

Other symptoms include:

    Weight loss.

  • Lumpy skin.

  • Skin necrosis.

  • Eye pain.

  • Skin ulcers.

  • Itching.

  • Red scaly rash in skin.

  • Insomnia.

  • Cough.

  • Enlarged spleen.

  • Enlarged liver.

Skin conditions include:

    Tumors.

  • Patches.

  • Lesions.

Diagnosis:

The diagnosis of early mycosis fungoides often needs integration of clinical, histological and molecular features since it can be confused with benign eczematous skin disease.

Some of investigation needed to confirm diagnosis include:

    Liver function tests: lactate dehydrogenase (LDH) is a marker of bulky or biologically aggressive disease. Abnormal transaminase values may indicate hepatic involvement.

  • Uric acid: May be raised in aggressive disease.

  • Consider HIV testing (but the vast majority of patients are HIV-negative).

  • Chest X-ray.

  • CT scan of the abdomen and pelvis: In patients with advanced disease (stage IIB to stage IVB) or in patients with clinically suspected visceral disease.

  • Skin biopsy: For a definitive diagnosis, skin biopsy shows mycosis or "S

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