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General Information: Persistent Rashes: Mycosis Fungoides

Mycosis fungoides is a condition in which the skin is infiltrated by patches or lumps composed of white cells called lymphocytes. It is more common in men than women and is very rare in children. Its cause is unknown but in some patients it is associated with a pre-existing contact allergic dermatitis or infection with a retrovirus.

Mycosis fungoides has an indolent (low-grade) clinical course, which means that it may persist in one stage or over years or sometimes decades, slowly progress to another stage (from patches to thicker plaques and eventually to tumors).

Investigations
The diagnosis of cutaneous T-cell lymphoma is made by a dermatopathologist as there are characteristic microscopic changes seen on skin biopsy. The diagnosis is often delayed for months or years and may require several biopsies, as early cutaneous T-cell lymphoma can be difficult to tell apart from other skin conditions, particularly eczema.

Treatment
Treatment of individual patients varies, and depends on the stage, local expertise and available drugs and equipment. The following may be useful.

• Topical steroids
• UVB Phototherapy
• PUVA Photochemotherapy
• Topical nitrogen mustard
• Bexarotene gel (a topical rexinoid)
• Chemotherapy
• Localised radiotherapy
• Electron beam radiotherapy
• Interferons
• Oral retinoids
• topheresis.
• Prognosis

Cutaneous T-cell lymphoma may remain confined to the skin for many years, but the abnormal cells may eventually infiltrate other tissues including blood, lymph nodes, lungs, heart, liver and spleen. Unlike some other lymphomas, the outlook is generally good. Symptoms can usually be controlled with treatment. However treatment is not curative.

 

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