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10

NCCN Guidelines for Patients

®

Mycosis Fungoides, Version 1.2016

1

Mycosis fungoides basics

Do I have mycosis fungoides?

Do I have mycosis fungoides?

The most common sign of mycosis fungoides is skin

lesions. A lesion is any type of abnormal skin. Skin

lesions of mycosis fungoides may be confined to a

small area of the skin or may be widespread. They

may wax and wane but persist over time. Types of

skin lesions include:

Patch

– an area of scaly skin that is flat and

may be discolored,

Papule

– a red bump that is by a hair follicle,

Plaque

– a thickened patch that is raised or

hard,

Tumor

– a firm, dome-shaped mass at least

1 cm in size, and

Erythroderma

– a reddening and scaling of

most or all of the skin.

Skin lesions may itch, have no hair, and get infected.

It is sometimes hard to tell mycosis fungoides apart

from other skin conditions. It can look like psoriasis,

eczema, or an allergic reaction. When your doctor

suspects mycosis fungoides, testing is needed. The

tests that are needed to confirm (diagnose) mycosis

fungoides are described next.

Biopsy

Samples of skin lesions must be removed from your

body and be tested to diagnose mycosis fungoides.

Testing of more than one lesion is very helpful for

diagnosis. A biopsy is a procedure that removes

tissue samples. There are multiple types of skin

biopsies. Which one you will have depends on how

large and where the abnormal skin is. Skin biopsies

include:

Punch biopsies

– As shown in

Figure 1.4

, a

sharp hollow device—like a cookie cutter—is

used to remove a small but deep sample of

both skin layers, and

Shave biopsies

– A surgical knife or razor

blade is used to remove the first layer of skin

and part of the second layer.

Except for moisturizers, don’t use skin treatments

2 to 4 weeks before the skin biopsy. Right before

the biopsy, your skin will be numbed with local

anesthesia. You may feel pressure during the biopsy,

but no pain. Afterward, your doctor may close the

wound and apply a bandage. Often, there are no side

effects, but some people do get scars.

Some people may also have a biopsy of enlarged

lymph nodes. A lymph node biopsy is often done

when the skin biopsy results are unclear. An

excisional biopsy is often the best method. This

biopsy removes the entire tumor. If an excisional

biopsy isn’t possible, a core needle biopsy, which

removes small samples with a needle, may be done.