Itching, itching, itching and peeling may also be cancer?

Review expert: Zhang Yuhong, chief physician of the Department of Dermatology, Zhengzhou Central Hospital Affiliated to Zhengzhou University

Recently, there was a news report that a young man in Guangdong has been troubled by dandruff and white spots on his body since he was 12 years old. When he took off his clothes, a lot of dandruff would fall off. Because of the particularity of this symptom and the fact that students inevitably live in a group, he suffered from strange looks from people around him.

Source: Weibo screenshot

In the first few years, he went to all the hospitals nearby. The doctors diagnosed it as a skin disease and prescribed a lot of topical and oral medicines, but the condition did not improve. It was not until he went to college that he met an experienced doctor in a hospital in Xiaoshan. The doctor told him that this was not a skin disease, but a cancer called "mycosis fungoides"!

What is mycosis fungoides?

Mycosis fungoides, also known as mycosis fungoides, is a type of skin T-cell lymphoma . Because it usually manifests as symptoms on the skin, such as erythema, peeling, and unbearable itching, it is often misdiagnosed at first. If it is misdiagnosed as a skin disease, once the tumor cells invade the lymph nodes and internal organs, the patient's survival rate will be greatly reduced.

Fortunately, the progression of mycosis fungoides is a slow, painless process. From the early to late stages, skin damage often manifests as remission and deterioration. The three-stage "evolution" process is:

1. Erythematous stage: usually occurs on the trunk and develops to the next stage after 2 to 5 years.

Source: Medical Family

2. Plaque stage: localized plaques accompanied by extreme itching.

Source: 39 Health Network

3. Tumor stage: generally a painless mass. During this stage, the lesion can spread to surrounding blood vessels, involving lymph nodes, bone marrow and internal organs.

The clinical manifestations of the above three stages are sometimes difficult to distinguish strictly. Each stage may last for 8-9 years, and the whole process may take at least more than ten years. The manifestations of the three stages can coexist in the same patient. Due to the extensive inflammatory response, early diagnosis is extremely difficult.

So if you feel something strange on your skin, how do you tell if you have mycosis fungoides? What are the specific symptoms in the early stages?

What are the early symptoms of mycosis fungoides?

Mycosis fungoides has various forms and is easily confused with other diseases. These include some skin diseases and primary peripheral T-cell lymphoma of the skin, anaplastic large cell lymphoma, etc. Inflammatory skin diseases such as allergic dermatitis and chronic superficial dermatitis may show symptoms similar to mycosis fungoides in the erythema stage. Patients with mycosis fungoides generally have patches, plaques or erythroderma changes first, while anaplastic large cell lymphoma does not, so it is important to combine clinical history.

Source: Wikipedia/Bobjgalindo

The bad news is that mycosis fungoides infection presents different characteristics in different patients. Mycosis fungoides may occur in any part of the human body, but it is more likely to invade the skin that cannot be exposed to the sun, forming plaques, patches, lumps, etc. Different skin symptoms have different names in clinical practice and are called "skin lesions."

Let’s take a look at the different skin lesions of mycosis fungoides:

1. The spots are flat and may be smooth or scaly, and look like diseases such as "eczema" and "dermatitis".

2. The patches are thick, raised, and often scaly. Before a clear diagnosis, these mycosis fungoides patches can be easily confused with eczema, psoriasis, and other types of diseases.

3. A tumor is a raised lump or nodule with or without ulceration.

Although these three types of skin lesions may coexist, most patients will only develop 1-2 types of skin lesions after many years, many patients will only develop patches and plaques, and only a very small number of patients will develop tumors. The most common symptom of mycosis fungoides infection is itching, which occurs in more than 80% of patients.

How is mycosis fungoides treated?

Mycosis fungoides is most common in adults, with a median age of 55 to 60 years at diagnosis, and a few cases are also seen in children. The cause and pathogenesis are currently unknown, but it is speculated that it may be related to long-term antigenic reagent stimulation, smoking, medications used, long-term exposure to solar ultraviolet radiation, and certain viral infections . There is currently no evidence that it is hereditary. The good news is that mycosis fungoides is not a contagious disease and is not transmitted from person to person. There are a variety of treatment options for patients with patch and plaque stages of mycosis fungoides. It is generally recommended to use local treatment for skin lesions; due to the poor prognosis of patients in the tumor stage, combined chemotherapy is often recommended, and patients should be thoroughly examined to rule out the spread of visceral tissues and the blood system.

Source: Physician's Newspaper

The recovery of patients with mycosis fungoides depends on the stage of the disease, especially the type and range of skin damage. If mycosis fungoides has invaded the patient's lymph nodes, internal organs, etc., the patient will often die due to systemic invasion or infection. Of course, although there are many patients, the probability of ordinary people contracting mycosis fungoides is not high, so there is no need to worry too much . When the corresponding symptoms appear on the skin, you need to seek medical attention in time and take medication as prescribed by the doctor. If you find that the skin disease has not subsided for a long time, you need to go to a more professional hospital for diagnosis and treatment.