Mycosis fungoides

Mycosis Fungoides, also known as Alibert-Bazin syndrome or granuloma fungoides, is a rare form of non-Hodgkin's lymphoma. It generally affects the skin, but may progress internally over time. more...

Mycosis Fungoides was first described in 1806 by French dermatologist Jean-Louis-Marc Alibert. The name mycosis fungoides is somewhat confusing because it sounds, to the uninitiated, like a type of fungal infection. In reality, mycosis fungoides is unrelated to fungus and the fungoides portion derives from a patient with a severe case whom Alibert described as having mushroom-like skin tumors.

Origins and causes

The cause of mycosis fungoides is unknown, and is not believed to be hereditary or genetic. It is not contagious.

It is rare for the disease to appear before age 20, and it appears to be noticeably more common in males than females, especially over the age of 50, where the incidence of the disease (the risk per person in the population) does increase. The average age of onset is between 45 and 55 years of age for patients with patch and plaque disease only, but is over 60 for patients who present with tumours, erythroderma (red skin) or a leukemic form (the Sézary syndrome).

The disease is an unusual expression of T-cells, a part of the immune system. These T-cells are skin-associated, meaning that they biochemically and biologically are most related to the skin, in a dynamic manner. Mycosis Fungoides is the most common type of 'Cutaneous T-cell Lymphoma' (CTCL), but there are many other types of CTCL that have nothing to do with Mycosis Fungoides and these disorders are treated differently.

Symptoms, diagnosis, and stages

Typical visible symptoms include rashlike patches, tumors, or lesions. Itching (pruritus) is common, perhaps in 20% of patients, and is not universal.

Diagnosis is sometimes difficult because the early phases of the disease often resemble eczema or even psoriasis. As with any serious disease, it is advisable to pursue the opinion of a medical professional if a case is suspected. Diagnosis is generally accomplished through a skin biopsy. Several biopsies are recommended, to be more certain of the diagnosis. The diagnosis is made through a combination of the clinical picture and examination, and is confirmed by biopsy.

To stage the disease, various tests may be ordered, to assess nodes, blood and internal organs, but most patients present with disease apparently confined to the skin, as patches (flat spots) and plaques (slightly raised or 'wrinkled' spots).

Treatments and cures

Mycosis fungoides can be treated in a variety of ways.

If treatment is successful the disease can go into a non-progressing state with clinically clear examination and various tests. This is called remission; it can last indefinitely. Treatments may also cause disease not to progress, while still present, and this is called stable disease; it may last indefinitely but is a more serious situation. Disease may also progress, to involve nodes, blood and internal organs, or transform into a higher-grade lymphoma.

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