Mycosis fungoides is a main subtype of a cutaneous T cell lymphoma (CTCL), in which a heterogeneous collection of lymphomas develop into malignant cancer cells, primarily affecting the skin. This disease can be distinguished from other cutaneous T cell lymphomas by its unique clinical and histologic features (Armitage et al., 2010). Mycosis fungoides can be treated several different ways and is dependent on several factors such as the stage of the cancer, health of the patient, presenting symptoms and patient-specific issues (Parker & Bradley, 2006). Traditional therapies for mycosis fungoides involved radiation therapy, oral psoralen with UVA light therapy and narrow- and broadband UVB light therapy. Recently, novel therapies have been established to treat CTCL and several of them are starting to become routine therapies for the erythrodermic subgroup of mycosis fungoides. This paper will discuss the historical background of the disease as well as the new techniques that have been used within the past few years and the traditional methods of treatment.
T cells are genetically prepared to protect and survey the human body from any environmental stressors, foreign agents and malignancy. Some of these T cells are programmed to protect the skin. Once the body is infected with T lymphocytes, the T cells infiltrate the skin, work together to eradicate the allergen and eventually they undergo the process of natural cell death. However, when specific skin-homing T lymphocytes infect the skin, they then clonally expand and are sometimes unable to exit the skin compartment. Once the lymphocytes accumulate within the skin, the reaction is then known as a rash. This proliferation of abnormal cloning of T cells within the skin distinguishes CTCL and its most common variant, mycosis fungoides (Parker & Bradley, 2006).
In the 1800s, a French dermatologist named mycosis fungoides after the presenting symptoms of mushroom like tumors that progressed on the skin. Mycosis fungoides is more common in men than women, adults around the ages 55-65 years and typically in more African Americans in the United States (Parker & Bradley, 2006). Though mycosis fungoides is rare, it accounts for 4% of all non-Hodgkin lymphomas (Armitage et al., 2010). The etiology of the disease is unknown. There have been studies about the cause of mycosis fungoides that proposed a role for chemical exposure as a source of chronic antigenic stimulation or toxic exposure, but recent reports disprove this hypothesis (Canellos, Lister & Young, 2006).
The most common symptom of mycosis fungoides is pruritus, which is present even in early stages of the disease (Armitage et al., 2010). Generally most patients with mycosis fungoides start with dry, mild itchy patches located on the skin. The lesions often appear red however; in darker individuals they may become darker or lighter than the natural skin color (Parker & Bradley, 2006). The distribution and shape of the lesions vary, but they do...