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Mycosis fungoides is the most common type of cutaneous T-cell lymphoma (CTCL). It is a non-Hodgkin lymphoma that starts in T-cell lymphocytes and primarily affects the skin. It often develops slowly over many years and can be mistaken for more common skin conditions, especially in its early stages.
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How Mycosis Fungoides Develops on the Skin
Mycosis fungoides may develop in these phases:
- Premycotic phase: During this phase, a red, scaly rash begins to appear in areas of the body that usually are not exposed to the sun. It does not cause symptoms and can be long-lasting and hard to diagnose at this phase.
- Patch phase: During the patch phase a thin, reddened, rash appears that can seem like eczema.
- Plaque phase: During this phase papules appear (these are small, raised bumps) and hardened lesions form on the skin. They may be reddened.
- Tumor phase: Tumors form on the skin and can turn into ulcers. This may cause the skin to become infected.
Mycosis Fungoides Staging
Staging is the process of determining how far a disease has spread. Knowing the stage is important because a patient's treatment and the prognosis (chance of recovery) depend on the stage. Physical exams, imaging tests (such as a CT scan), biopsies and blood tests are used to determine stage.
Mycosis fungoides (and Sézary syndrome) are staged differently than the rest of the cutaneous lymphomas. They are grouped into overall stages of I (1) through IV (4), which may be further subdivided into A and B. Learn more about these stages.
A TNM staging system is used for the other cutaneous lymphomas types, including primary cutaneous follicle-center lymphoma.
How Mycosis Fungoides is Diagnosed
A clear diagnosis helps your care team distinguish mycosis fungoides from other CTCL types and from non‑cancerous conditions that can look similar. Different tests and procedures may be used to diagnose mycosis fungoides, such as:
- Physical exam: A physician checks for general signs of health as well as signs of disease, such as lumps or skin lesions. Pictures of the skin will be taken and a history of the patient's health and past issues or treatments will also be recorded.
- Blood test: A procedure called a complete blood count (CBC) is performed on a sample of blood that is drawn.
- Skin biopsy: Small samples of skin are taken and examined under a microscope by a pathologist.
Treatment Options for Mycosis Fungoides
Treatment for mycosis fungoides is tailored to the stage of disease, your symptoms and your overall health. Many people receive more than one type of treatment over time.
- Photodynamic therapy: Use a drug and laser light to destroy cancer cells
- Radiation therapy: Uses high-energy X-rays and other types of radiation to destroy cancer and prevent them from growing
- Chemotherapy: Uses drugs to stop the cancer from growing
- Other Drug therapy: Such as steroids and retinoids
- Immunotherapies: Therapies that use the body’s own immune system to fight the disease
- Targeted therapies: Uses drugs or substances to identify and attack certain cancerous cells.
In certain cases, high-dose chemotherapy and radiation therapy with blood and marrow transplant may be an option. Additionally, some patients may be eligible for and decide to join a clinical trial where new treatments are being studied