Have you suddenly developed a rash or scaly rash on your skin, especially in areas that are not exposed to the sun, such as your stomach or thighs? They may itch or look like eczema. While many people think this is a normal skin problem, sometimes it can be an early sign of a rare skin condition called Mycosis Fungoides. Don't worry, we'll talk about this in detail.
Simply put, what is Mycosis Fungoides?
The name suggests a fungal infection, but it's not. Mycosis Fungoides is actually a condition caused by T cells, a type of white blood cell in our blood, turning into cancer cells.
Think of it this way, these T cells are like soldiers in our bodies. Their job is to protect us from diseases by fighting germs like viruses and bacteria that enter the body. But in this disease, these same T cells turn into cancer cells and start affecting our skin.
This disease belongs to a group of cancers called Cutaneous T-cell Lymphoma (CTCL) . That is, it is a T-cell lymphoma that affects the skin. So remember, this is not a skin cancer, it is a blood cancer that affects the skin. It is not the skin cells, but the T cells in the blood that become cancer cells here.
What are the symptoms of this disease? How does it change from stage to stage?
Mycosis Fungoides symptoms do not come on suddenly. They appear in stages, with changes in the skin. However, not everyone experiences all of these stages. Some people may have several stages at the same time.
To make it easier to understand, let's look at these stages.
| Stage | Appearance and Symptoms |
|---|---|
| Premycotic stage | A scaly rash develops. These are most commonly seen in areas not exposed to the sun, such as the lower abdomen, thighs, buttocks, and breasts. |
| Patch phase | The skin around the rash becomes thinner. These spots may be itchy and dry. They may look like eczema. |
| Plaque stage | Small, raised bumps or plaques appear on the skin. These are hard, raised bumps that can be felt in the hand. |
| Tumor stage | Tumors form on the skin. These go deeper into the skin than the previously mentioned plaques. They can most commonly occur on the thighs, groin, armpits, and inner elbows. These tumors can also become infected if they become injured. |
When this condition becomes severe, large numbers of cancerous T cells begin to circulate in the blood. These cells are called Sézary cells . If these cells become too numerous in the blood, the condition can develop into a condition called Sézary Syndrome . This can cause a red rash all over the body.
Why does something like this happen?
The exact cause of this is not yet known , but experts believe that genetic mutations may play a role. Simply put, it is thought that errors in the DNA in our cells cause T cells to become cancerous.
But the important thing is that these genetic changes are not passed down from generation to generation. That means you don't develop them just because your parents had them. Researchers are still investigating whether certain environmental toxins or infections can cause this.
The most important thing is that Mycosis Fungoides is not a contagious disease. It is not transmitted from one person to another in any way.
How does a doctor find this?
Diagnosing this disease can be a bit challenging because in the early stages, its symptoms are very similar to common skin conditions like eczema or psoriasis. Therefore, it is difficult to tell if it is Mycosis Fungoides just by looking at the skin.
Therefore, your doctor will perform several additional tests to confirm or rule out this disease.
- Skin biopsy: This is the most important test. A small piece of tissue is taken from the affected area of the skin and examined in a lab. This tissue is then tested for the presence of cancer cells associated with Mycosis Fungoides. It may be necessary to do several biopsies to find the exact cancer cells.
- Blood tests: A blood sample is taken and changes in the blood cells and certain chemical markers are looked at.
- Imaging procedures: Tests such as a CT scan or PET scan may be done to see if the cancer has spread to the lymph nodes or other internal organs.
How is the stage of the disease determined?
Once the disease is diagnosed, doctors will determine its 'stage'. This is a classification of how far the cancer has spread and how severe it is, from stage I to IV. This is very important in planning the best treatment for you.
When deciding on this stage, the following points are taken into account:
- The size of skin lesions (spots, boils, boils).
- How much of the skin these lesions have spread to.
- Has the cancer spread to the lymph nodes?
- Have cancer cells entered the blood?
- Has it spread to other organs besides the skin?
What are the treatments for this?
Treatment for Mycosis Fungoides depends on the stage of the disease and the changes in your skin. The primary goal of most treatments is to control symptoms and maintain your quality of life.
Your doctor may prescribe treatments like these:
- Skin-directed therapy: These are treatments that are applied directly to the affected areas of the skin. These include topical gels, steroids, retinoids, and phototherapy .
- Systemic therapy: These are drugs given as pills or intravenously. They affect cancer cells throughout the body. Examples include drugs like methotrexate .
- Immunotherapy: This involves stimulating our own immune system to identify and destroy cancer cells.
- Targeted therapy: These drugs directly identify and destroy only cancer cells, thus causing less damage to normal cells.
- Radiation therapy: The use of powerful energy beams to destroy cancer cells or stop their growth.
Chemotherapy, the treatment we usually hear about when we talk about cancer, is not widely used for this disease because it is not very effective for this disease and has many side effects.
What will life be like with this disease?
There is no cure for this disease yet . But don't worry. With early detection and treatment, many people can live a normal life without any symptoms for years.
Your prognosis depends on several factors, the most important of which is the stage of the disease.
According to statistics, if diagnosed in the early stages (early-stage), the probability of surviving 10 years is as high as 95%. If the disease becomes severe (advanced-stage), this time can be reduced to three to five years. But remember that these are just numbers. Many things affect this, such as your age and overall health. Therefore, only your doctor can give you the best description of your condition.
Can this be prevented? What should I do?
There is no proven way to prevent Mycosis Fungoides from developing. But there are things you can do to reduce the risk of the disease progressing to a more serious stage. That is, go for regular medical checkups.
The most important thing is to check your skin yourself at least once a month. Go to a mirror and look all over your body. Look for new spots, moles, warts, or changes in color or size of existing ones. If you notice any changes, don't ignore them and see a dermatologist right away. The sooner you detect them, the more successful the treatment.
Questions to ask your doctor
If you are diagnosed with this disease, you may have many questions in your mind. Don't hold anything back, ask your doctor.
- What treatment options do I have?
- Are there any side effects to these treatments?
- What is the chance of the disease coming back after treatment?
- What happens if I don't get treatment?
- What can I do to prevent the disease from coming back?
Take-Home Message
- Mycosis Fungoides is not a cancer of the skin cells. It is a cancer that occurs in the T cells of the blood, but affects the skin.
- In the early stages, its symptoms are very similar to common skin conditions like eczema or psoriasis.
- This disease is not contagious at all. There is no need to be afraid of passing it from one person to another.
- Early detection of the disease is very important for successful treatment and a long, healthy life.
- If you are suspicious of any new, persistent, or changing spot, lesion, or lump on your skin, see a doctor immediately.
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