Mycosis Fungoides

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THIRTEEN patients with mycosis fungoides have been seen at the Cleveland Clinic. Nine were men and 4 women. The youngest patient to develop the disease in this series was a 22-year-old woman and the oldest a woman aged 71.

Twelve of the patients were white and 1 was colored. Occupation was not significant. The duration of the disease before being seen at the Clinic varied from 1 month to 10 years.

One patient developed dermatitis venenata which was followed by a generalized exfoliative dermatitis on which lesions of mycosis fungoides developed 4 years later. Another patient had “psoriasis” for 30 years and then developed mycosis fungoides. One patient had mycosis fungoides of the d’emblee type. Nine complained of pruritus and in 3 cases this was severe. Sensation of burning was present in 1 case. Two patients were asymptomatic. Enlargement of the superficial lymph nodes was observed in 6 patients.

On admission to the Clinic 2 patients had exfoliative dermatitis; the others presented nodules, erythematous scaly plaques, ulcers, papules, and macules. Concomitant diseases were syphilis, psoriasis and carcinoma of the esophagus.

Diagnosis is often difficult. The clinical diagnosis of mycosis fungoides or lymphoblastoma was entertained in 11 cases on entrance to the Clinic. In 1 case syphilis was first considered; in the patient with the d’emblee type of lesion, three possibilities were first considered in differential diagnosis: (1) neoplasm, (2) factitia dermatitis, and (3) melanoma.

In 10 cases biopsy showed histologic pictures consistent with mycosis fungoides. Three were diagnosed as lymphoblastoma. . .



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