Overview
Mycosis fungoides is a rare type of lymphoma that mainly affects the skin. Lymphoma is a cancer that begins in the lymphocytes, which are a type of white blood cell. The white blood cells are part of the body's germ-fighting immune system.
There are many types of lymphoma. These types are often divided into two categories: Hodgkin lymphoma and non-Hodgkin lymphoma. Mycosis fungoides is a type of non-Hodgkin lymphoma.
Mycosis fungoides got its name from the appearance of some of its skin growths, which may look like mushrooms. Mycosis fungoides got its name from the mushroom like look of some of its skin growths. It is not caused by a fungus. It begins in white blood cells called T cells, also called T lymphocytes. The T cells undergo changes and turn into cancer cells. In mycosis fungoides, the T cells attack the skin. Mycosis fungoides is one of a few types of lymphoma that affect T cells in the skin, called cutaneous T-cell lymphomas.
Mycosis fungoides typically grows slowly. As it grows, it sometimes spreads to the lymph nodes, blood and organs. It is often hard to diagnose early. It usually looks like other skin conditions such as eczema, also called atopic dermatitis, and psoriasis when it starts.
A mycosis fungoides rash can sometimes lessen or go away and come back. This cycle can repeat for months or years before the rash becomes worse. Mycosis fungoides is also easy to miss in tests such as biopsies when it first appears. The sampled cells might look like cells from a typical rash under the microscope. Sometimes cells have to be sampled and studied many times before a diagnosis is reached.
Treatments may include skin creams, light therapy, radiation therapy, immunotherapy and chemotherapy or a combination of several of these options. These treatments can help manage the disease and improve quality of life.
Types
There are several types of mycosis fungoides. These include:
- Hypopigmented mycosis fungoides. This type causes scaly patches on the skin that look lighter in color compared with the skin surrounding it. It typically affects children and people with Black and brown skin.
- Folliculotropic mycosis fungoides. This type affects the hair follicles. A hair follicle is where hair grows from. This type can look like bumps, acne spots or patches. It typically affects adult men, but children also may be affected.
- Granulomatous slack skin. This rare type causes loose, hanging folds in the skin. It can also cause clusters of cells called masses in areas such as the armpits and groin. It typically affects men in their 20s and 30s.
- Pagetoid reticulosis. This rare type often shows up as one wartlike or scaly patch, typically on a hand or foot. It usually affects men in their 40s and 50s but can happen at any age.
- Poikiloderma mycosis fungoides. This type looks like thin patches of skin that are wrinkled, light and dark, and show blood vessels.
Sometimes people wonder how mycosis fungoides compares to another cutaneous T-cell lymphoma called Sezary syndrome. Like mycosis fungoides, Sezary syndrome also looks like eczema and psoriasis in its early stages. It differs from mycosis fungoides in that it usually expands quickly. In time, Sezary syndrome can cause a rash over the whole body. In addition to the skin, Sezary syndrome often also affects the blood early in the disease.
Symptoms
Signs and symptoms of mycosis fungoides vary depending on the area affected and if the cancer is in early or late stages.
Early-stage symptoms include:
- Patches of rash on the skin. The patches usually show up on skin that doesn't get much sun, including the breasts, buttocks and upper thighs. It also can show up on the face, scalp, palms and soles, though that is less common. On white skin, the patches may appear pink or red. On brown skin, they might look pink, red, deep red or purple. On Black skin, they may look pink, purple, gray or dark brown.
- The patches can sometimes be lighter or darker than surrounding skin and have a wrinkled pattern.
- Patches of scaly skin.
- Skin that may itch constantly or from time to time.
- Spots on the skin that are in different shapes and sizes.
Late-stage symptoms include:
- Thicker areas of raised skin called plaques that cover greater areas of the skin.
- Skin growths that are red or purple depending on your skin color.
- Lumps that form on the skin that may break open or become infected.
- Worsened itching.
- Swollen lymph nodes.
- Hair loss.
When to see a doctor
Make an appointment with a healthcare professional if you have symptoms that worry you or are not going away.
Causes
Mycosis fungoides begins in white blood cells called T cells, also called T lymphocytes. The T cells undergo changes and turn into cancer cells. A cell's DNA holds instructions that tell the cell what to do and when to die. Because of these DNA changes, the cells stop dying. They usually multiply and form a skin patch or a mass. Exactly why the DNA changes happen is not known.
Risk factors
The risk of mycosis fungoides may be higher in:
- Older adults. The condition can happen at any age, but it's more common in people in their 50s and older.
- People who were born male. The condition is twice as common in people who were born male than it is people who were born female.
- Black people. Black people have the highest risk of getting mycosis fungoides and are more likely to get this cancer at an earlier age.
There is no known way to prevent mycosis fungoides.
Complications
Mycosis fungoides may lead to skin infections due to breaks in the skin.