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Mycosis Fungoides - Causes, Symptoms and Treatment


Definition

Mycosis fungoides is the most common of the cutaneous T-cell lymphomas, a group of rare cancers that grow in the skin. In 1979, the term cutaneous T-cell lymphoma 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 individuals with mycosis fungoides, the skin becomes infiltrated with plaques and nodules that are composed of lymphocytes. In advanced cases, ulcerated tumors and infiltration of lymph nodes by diseased cells may occur. The disorder may spread to other parts of the body including the gastrointestinal system, liver, spleen, or brain. 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. If the classic histologic features are present associated with characteristic clinical features, the diagnosis can usually be made.

Causes

  1. The correct cause is unknown.
  2. Genetic predisposition may be one of the risks. The people having one or more family member have high risks to cause this disease.
  3. Causative agents such as long-term exposure to industrial or environmental metals, organic solvents, chemical carcinogens, pesticides and herbicides may also cause this disease.
  4. Age also plays a crucial role in this disease. It is most common in the 40-60 year old age group.
  5. It is not contagious. It does not spread by contact or orally from one person to another.
  6. The number of cutaneous T-cell lymphocytes in the blood may also be a considerable factor.

Symptoms

  1. In this disease there may be flat patches, plaques, or tumors, which may have a long natural history.
  2. Early in the course of mycosis fungoids as well as in erythrodermic cases, skin lesions may be nonspecific, with a nondiagnostic biopsy result, so confusion with benign conditions is common.
  3. 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.
  4. Diagnosis is generally accomplished through a skin biopsy. Several biopsies are recommended, to be more certain of the diagnosis. Diagnosis is sometimes difficult because the early phases of the disease often resemble eczema or even psoriasis.
  5. Chronic intermittent, itchy rash can appear anywhere on the surface of the body.

Treatment

  1. Treatment for cutaneous T-cell lymphoma depends on the type and how far it has spread.
  2. If the cancer is confined to the skin, it may be treated with chemotherapy such as nitrogen mustard applied to the skin.
  3. Drug psoralen combined with ultraviolet-A light can be used at this i.e. first stage.
  4. If the disease is little complicated then Radiotherapy may be used for stubborn areas which do not respond to the other treatments. Radiation therapy is usually very effective. Radiotherapy to the whole skin surface may be used if these treatments are not effective.
  5. Severe cases usually treated with chemotherapy. Whole skin radiotherapy is not used here.
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