Pathogenesis (disease development) Mycosis fungoides is a disease that originates in the T cells of lymphoid tissue. It is thought to have a multicausal (caused by many factors) pathogenesis. In part, mycosis fungoides develops via prelymphomas such as large-bore or poikilodermatous (variegated) parapsoriasis (psoriasis; chronic skin disease resembling psoriasis) or lamphomatoid papulosis (chronic disease with … Mycosis Fungoides: Causes
General measures Nicotine restriction (refraining from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Conventional non-surgical therapy methods PUVA therapy – This term stands for the combined use of UVA light (UV-A phototherapy) and psoralen. Psoralen are substances that have a photosensitizing effect on … Mycosis Fungoides: Therapy
Blood, hematopoietic organs-immune system (D50-D90). Sarcoidosis (synonyms: Boeck’s disease; Schaumann-Besnier’s disease) – systemic connective tissue disease with granuloma formation (skin, lungs, and lymph nodes). Nonspecific reactive lymphadenopathy (lymph node enlargement). Skin and subcutaneous tissue (L00-L99) Atopic eczema (neurodermatitis) Eczema – dermatitis (skin inflammation), especially with pruritus (itching) and erythroderma (areal redness of the skin). Parapsoriasis … Mycosis Fungoides: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be co-morbid with mycosis fungoides: Blood, blood-forming organs – Immune system (D50-D90). Immunosuppression – probably due to factors secreted (released) by the lymphoma. Neoplasms – tumor diseases (C00-D48). Infestation of internal organs Transition to highly malignant (highly malignant) T-cell lymphoma (large T-cell lymphoma). Further … Mycosis Fungoides: Complications
Mycosis fungoides is classified into four stages: Stage Description/complaints Duration Stage I:Premycous stage(eczema stage). Uncharacteristic skin rashes such as large-hearted parapsoriasis (psoriasis) or eczema (skin inflammation; “itchy rash”) Yellowish-brownish non-infiltrated foci Efflorescences (visible skin changes) may disappear and reappear in other locations. However, they may also persist (persist). Pruritus (itching) No lymphadenopathy (enlarged lymph nodes). … Mycosis Fungoides: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Examination of the entire skin![Eczema (skin inflammation); erythroderma (extensive skin redness); solitary standing or cushion-like confluent nodules; yellowish-brownish non-infiltrated foci; indurated palpable; livid-reddish nodules or plaques (“plate-like” substance proliferation … Mycosis Fungoides: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Differential blood count [lymphocytosis (increase in the number of lymphocytes in the blood), eosinophilia (increase in the number of the number of eosinophilic granulocytes)] Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase … Mycosis Fungoides: Test and Diagnosis
Therapeutic targets Symptomatic therapy Remission (regression) Improvement in the quality of life Therapy recommendations Therapy for mycosis fungoides is stage-dependent. Stage 1 and 2: Local therapy: Topical glucocorticoids (class III and IV) in the form of ointments or creams. Retinoids: bexarotene – specifically designed to treat mycosis fungoides; induces apoptosis (programmed cell death) of tumor … Mycosis Fungoides: Drug Therapy
Obligatory medical device diagnostics. due toExtracutaneous (“outside the skin”) manifestation of mycosis fungoides: Abdominal sonography (ultrasound examination of the abdominal organs). Computed tomography (CT) of the abdomen (abdominal CT)/pelvis (pelvic CT) – in advanced stages, whole-body CT. Magnetic resonance imaging of the abdomen (abdominal MRI)/pelvis (pelvic MRI). X-ray of the thorax (X-ray thorax/chest), in two … Mycosis Fungoides: Diagnostic Tests
Radiotherapeutic measures for mycosis fungoides: Local radiatio (radiation therapy) with X-rays or electron beams for limited tumorous skin lesions; or whole-body irradiation with fast electrons (in special centers) → good results.
The following symptoms and complaints may indicate mycosis fungoides (stage-dependent): Stage I: Premycous stage (eczema stage). Uncharacteristic skin rashes, such as large-heart parapsoriasis (psoriasis) or eczema (skin inflammation; “itchy rash”) Yellowish-brownish non-infiltrated foci Efflorescences (visible skin changes) may disappear and reappear in other locations. However, they may also persist (persist). Pruritus (itching) Predilection sites (body … Mycosis Fungoides: Symptoms, Complaints, Signs
Medical history (history of illness) represents an important component in the diagnosis of mycosis fungoides. Family history What is the general health of your relatives? Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social history What is your profession? Current medical history/systemic history (somatic and … Mycosis Fungoides: Medical History
