Mycosis fungoides natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2]

If left untreated, mycosis fungoides may progress to develop cutaneous patches, plaque, and tumors. Depending on the extent of the lymphoma at the time of diagnosis, the prognosis may vary.

• The symptoms of mycosis fungoides usually develop as non-specific, indolent inflammation such as etopic dermatitis, nonspecific chronic dermatitis, or parapsoriasis ( large-plaque parapsoriasis).^[1]
• The majority of patients have early stage (77.9% : IA stage IA 38.8%, stage IB 39.1% ), and patients with stage IIB diagnosed in 5.5% and stage III observed in 6.6%. The majority of patients of mycosis fungoides are not diagnosed and end stage not be observed.^[1]
• Mycosis fungoides in early stage is characterized by non-specific dermatitis or consistent patches observed on the lower trunk and buttocks.^[1]
• Mycosis fungoides initiates as an indolent lymphoma that may later develop peripheral lymphadenopathy and may finally progress to widespread visceral involvement.^[2]
• Patients often have a history of several years of eczematous or dermatitis skin lesions before the diagnosis is finally established.^[1]
• The skin lesions then progress from the patch stage to the plaque stage to cutaneous tumors.^[1]

• Common complications of mycosis fungoides include:^{[3][4][5][6][7]}
  • Mycosis Fungoides increases risk of secondary malignancies such as primary malignancy, especially Hodgkin lymphoma, chronic leukemia, and lung cancer.
  • Neurologic involvement (intracerebral mycosis fungoides)
  • Oral involvement
  • Hypersensitivity reaction with topical HN2 therapy
  • Hypopigmentation or hyperpigmentation of treated areas

• Cutaneous T cell lymphoma is usually a slow-growing (indolent) lymphoma.^[8]
• The prognosis for people with cutaneous T cell lymphoma is based on the extent of disease and how the person responds to treatment.
• Although more advanced stages of cutaneous T cell lymphoma may not be cured, the lymphoma can still be controlled with treatment

• Early stage disease
• Lymphoma is confined to the skin

• More advanced disease
• Lymphoma has spread to lymph nodes
• Lymphoma has spread to other organs

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