Mycosis Fungoides

WHAT IS MYCOSIS FUNGOIDES? A Brief overview

The term cutaneous T-cell lymphoma (CTCL) was coined at an international workshop sponsored by the National Cancer Institute. CTCL was used to describe a heterogenous group of malignant T-cell lymphomas with primary manifestations in the skin. In 1806, the term mycosis fungoides (MF) was first used by Alibert, a French dermatologist, when he described a severe disorder in which large necrotic tumors resembling mushrooms presented on a patient's skin.

HOW COMMON IS IT?

In the US, approximately 1000 new cases occur annually. The average age of onset is 50 years of age. Males and African American patients are more commonly affected.

HOW DOES MF PRESENT ON THE SKIN?

MF infiltrates in the skin consist of tumor cells (T lymphocytes) a form of white blood cell. The rash usually begins as a nonspecific dermatitis which can mimic eczema and it is usually itchy. The actual inflammation may consist of flat patches, plaques, or tumors, which may have a long natural history. The median duration from the onset of skin symptoms to initial diagnosis is 6 years, so you can see it is a tricky disorder to get a handle on. Early in the course of disease, skin lesions may be nonspecific, with a nondiagnostic biopsy result, so confusion with benign conditions is common. It is important to obtain repeated biopsies in those patients who have progressive chronic dermatitis or whose condition is refractory to topical treatments such as steroids or moisturizers.

WHAT ARE THE CAUSES OF MF?

It has been proposed that occupational or environmental exposures (e.g., Agent Orange), and other forms of chronic antigenic stimulation, or viral exposures can cause MF; however, the etiology of MF remains unknown.

WHAT IS THE DIAGNOSTIC WORKUP?

Besides the obvious skin biopsy, ADAS providers will perform a Chest X-ray, blood work including flow cytometry studies and CT/ PET scans. If disease is found to be advanced, our providers will work with an oncologist (cancer doctor) to help manage the disorder.

WHAT IS THE TREATMENT FOR MF?

If mycosis fungoides is diagnosed in the early stage, treatments such as steroid creams, chemotherapy applied to the skin, or electron beam radiation may be used. The goal is to put the cancer in remission, which often lasts a long time.

If an individual's disease does not respond to the skin treatments, or the disease has progressed to the tumor stage, systemic treatments such as recombinant alfa-interferon or chemotherapy may be used. There is no cure for mycosis fungoides, so how long a person survives with the disease depends on how far it has spread by the time it is diagnosed and treatment begins. More often than not, patients live for many years with this disorder and serial evaluations at our office help to detect any progressions in the cancer staging.

For more information on mycosis fungoides or to set up a consultation, click here or call 904-285-7546. Thank you and we look forward to helping you.