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Mycosis fungoides is one of the more common cutaneous lymphomas that originate from peripheral T cells. It usually develops in elderly people, but the risk of developing the disease increases significantly after the age of 40.
The disease affects men more often than women. The mycosis granuloma (granuloma) was first described by the French dermatologist Jeon-Louis Alibert. The patient described by the doctor had large, mushroom-shaped necrotic lesions on the skin. It was an advanced form of the disease. The disease is named after a type of white blood cell called T lymphocytes. Cancer usually grows and progresses slowly. Often, its first symptom may be a rash with an undetermined cause.
Cutaneous lymphoma is a neoplasm characterized by infiltrates, erythema, and neoplastic T-lymphocytes. In mycosis fungoides, neoplastic T lymphocytes accumulate in the patient’s skin. It can spread to the lymph nodes, so it is very important to recognize it quickly.
Course of illness
The disease has several stages.
The introductory period is characterized by the development of flat, patchy, blemish-like, peeling, psoriatic or polymaric lesions on the skin. These changes may persist for many years in an unchanged shape. Usually they are also very itchy. It is characteristic that changes usually appear in places that are not exposed to sunlight.
The infiltrative period refers to erythematous eruptions around which infiltrative changes are formed. Then there is the formation of flat infiltrative lesions, which can often have a festoon or annular pattern and spread circumferentially. The itching gets worse.
The nodular period is the time when nodular eruptions form within the erythematous-infiltrative lesions. They can be pedunculated (they look like a button on a leg). These tend to fall apart. Ulcers form in their place. Individual tumors form the so-called confluent lesions that give the skin a distinctive look. At this stage of the disease, the lymphoma also affects the internal organs – the digestive tract, lungs, liver and spleen.
What is conducive to lymphoma?
So far, the causes of the disease cannot be stated with XNUMX% certainty. There are many hypotheses about the causes of the disease. Some scientists argue that the culprit may be skin exposure to certain factors in the work or home environment and exposure to viruses. There are also supporters of the theory that links the onset of the disease with chronic antigenic stimulation and exposure to viral antigens.
Diagnosis and treatment of the disease
Anyone who notices disturbing changes in the appearance of their skin should see a doctor so that he can assess the cause. If mycosis fungoides is suspected, a blood sample is taken from the patient for analysis, and a skin biopsy is also performed.
Blood tests allow you to assess the condition of internal organs. The tumor markers are also determined from the same blood sample. The aim of the biopsy is to detect changes in the skin typical of mycosis fungoides. The skin sample is examined under a microscope. One skin sample often does not give a clear picture of the condition. Therefore, to differentiate this lymphoma from other skin conditions, samples for analysis are taken from multiple sites on the body. Only the comparison of the obtained results allows us to make an accurate diagnosis. Special DNA tests can help speed up diagnosis.
How is kernel treated?
As with most cancers, the type of therapy depends on the severity of the disease, but the patient’s age and general health also play a role in initiating therapy. The range of treatment methods is large. The doctor may limit himself to the use of corticosteroids or, if the situation requires it, recommend chemotherapy.
In the initial and infiltrative period, irradiation with UVA rays, whole skin lubrication with nitrogranulogen, extracorporeal photophoresis, radiation therapy with small doses of X rays or fast electrons are used. When the disease enters the lumpy period, chemotherapy is usually used in conjunction with corticosteroids. It is worth adding that none of the forms of treatment slows down the progression of the disease, but brings the patient a significant relief from suffering.
The prognosis for patients with mycosis fungoides varies. Half of the affected patients survive. When cancer spreads to internal organs, it impairs their proper functioning. It also usually limits the body’s ability to fight infections. Mycosis fungoides is characterized by recurrences, therefore the patient and his doctor must carefully monitor the development of the disease and, if necessary, adjust the treatment to new threats.
The mental state of the patient is also important in the fight against the disease. The family has an important role to play. Help for patients with mycosis fungoides is also provided by support groups, i.e. patients suffering from the same disease. Understanding the essence of the disease and accepting the fact that it is impossible to completely control it has a positive effect on the course of treatment.
Tekst: Anna Jarosz