Mycosis Fungoides

Key Points
Slow-growing form of cutaneous T-cell lymphoma
Exact cause is unknown, but may be associated with other skin conditions or retrovirus infection
Initially consists of flat, pink lesions which may be oval or annular (ring-shaped), and may be accompanied by thinning of the skin or itching. Often on sun protected areas of the skin.

Mycosis fungoides is the most common form of cutaneous T-cell lymphoma, a rare condition which results in the buildup of abnormal lymphocytes. Mycosis fungoides is a slow-growing, or indolent, form of the condition, and affected persons may see years pass before the condition progresses to its next stage. Mycosis fungoides initially consists of flat, pink lesions which may be oval or annular, and may be accompanied by itching and thinning of the skin. This is known as the patch stage of the condition. In the plaque stage, lesions thicken and are accompanied by moderate itching. The tumor stage sees the development of large lumps of irregular shape on plaques, which may become ulcerated. Metastasization becomes more likely in the tumor stage than in previous stages.

There are also several symptomatic variants of Mycosis fungoides. These include folliculotropic MF (normal progression of the disorder affecting the areas around hair follicles, typically the on the head and/or neck, sometimes accompanied by Hair loss in the affected area), pagetoid reticulosis (consists of patches or plaques, usually on the extremities, caused by a buildup of neoplastic T-cells), and granulomatous slack skin (rare variant causing development of lax skin folds in areas with primary skin folds, such as the groin or armpits).

The exact cause of mycosis fungoides is unknown, but it is thought that it may be related to the presence of other skin conditions such as allergic contact dermatitis. It may also be associated with retroviral infection. The condition affects men at a higher rate than women, and is exceedingly rare in children.

Differential Diagnosis (Other conditions with similar appearance)
Lymphoma, Diffuse Large Cell
Lymphoma, Non-Hodgkin
Eczema
Neurodermatitis
Pseudolymphoma syndrome

Diagnosis
Key Points
Initial diagnosis based on characteristic appearance of the affected area
Skin biopsy will be performed to confirm diagnosis and rule out other conditions

Mycosis fungoides is initially diagnosed based on the characteristic appearance of the affected area. A skin biopsy will be performed to confirm the diagnosis and to rule out other, similar appearing conditions. Multiple biopsies may be needed for complete diagnosis.

Treatment
Method and success of treatment is predicated on severity of the condition and available treatments
*Various treatments may prove helpful in combating the condition

The method and success of treatment of mycosis fungoides is often dependent on the stage of the condition and the availability of treatment options. There are various treatment options which may prove helpful in combating the condition, including topical steroids, phototherapy, PUVA photochemotherapy, topical nitrogen mustard, bexarotene, chemotherapy, electron beam and/or localized radiotherapy, interferons, and photopheresis.