In the tumorous stage a dense infiltrate of medium-sized lymphocytes with cerebriform nuclei expands the dermis. Accurate staging of mycosis fungoides is essential to determine appropriate treatment and prognosis. Staging is based on the tumor, node, metastasis, blood (TNMB) classification proposed by the Mycosis Fungoides Cooperative Group and revised by the International Society for Cutaneous Lymphomas/European Organization of Research and Treatment of Cancer. This staging system examines the extent of skin involvement (T), presence of lymph node (N), visceral disease (M), and presence of Sezary cells in the peripheral blood (B).Most patients with mycosis fungoides have early-stage disease (Stage IA-IIA) at the time of their initial diagnosis. People with early stage disease that is primarily confined to the skin have a favorable prognosis. People with advanced stage (Stage IIB-IVB) are often refractory to treatment and have an unfavorable prognosis. Treatment options for people with advanced stage disease are designed to reduce tumor burden, delay disease progression, and preserve quality of life. Treatment
The most commonly recommended first-line treatment for mycosis fungoides is psoralen plus ultraviolet A (PUVA therapy). PUVA is a photochemotherapy that involves topical or oral administration of the photosensitizing drug psoralen followed by skin exposure to ultraviolet radiation. Systemic treatments of mycosis fungoides often lead to resistance; as such, additional treatment options are often necessary in advanced disease.Other treatments that have been suggested, however, larger and more extensive research is needed to identify effective treatment strategies for this disease.
After 11 years, the observed relative survival rate remained around 66%. Poorer survival is correlated with advanced age and black race. Superior survival was observed for married women compared with other gender and marital-status groups. The complete remission rate in children is nearly 30%. Epidemiology
It is rare for mycosis fungoides to appear before age 20; the average age of onset is between 45 and 55 years of age for people with patch and plaque disease only, but is over 60 for people who present with tumours, erythroderma (red skin) or a leukemic form (Sézary syndrome). Mycosis fungoides is more common in males than in females with differences in incidence across various racial groups reported in different studies. The incidence of mycosis fungoides was seen to be increasing between 2000 to 2020, although certain regions have demonstrated some stabilization. History
Mycosis fungoides was first described in 1806 by French dermatologist Jean-Louis-Marc Alibert. The name mycosis fungoides is very misleading—it loosely means "mushroom-like fungal disease". The disease, however, is not a fungal infection but rather a type of non-Hodgkins lymphoma. It was so named because Alibert described the skin tumors of a severe case as having a mushroom-like appearance. Culture and society
Notable cases
In 1995 actor Mr. T was diagnosed with a cutaneous T-cell lymphoma, or mycosis fungoides. Once in remission, he joked about the coincidence: "Can you imagine that? Cancer with my name on it — personalized cancer!" Popular British television actor Paul Eddington died of mycosis fungoides after living with the condition for four decades.