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Mycosis Fungoides : Prognosis

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Prognosis in Mycosis Fungoides (MF): MF pursues a protracted clinical course. The prognosis depends upon clinical stage which is determined by the nature and extent of the skin lesions, the presence or absence of nodal involvement, visceral involvement, and any peripheral blood involvement. Patients below 50 have much better survival than those over 60 years. Patients with advanced disease often have reduced numbers of functional helper T-cells. Sepsis usually occurs in the terminal phase of the disease.

Stage T1: Patches and plaques only at presentation and involving up to 10% of the body surface. Patient can expect normal life expectancy.

Stage T2: Patches and plaques cover >10% of the body surface. Median survival is 10-12 years. Risk of progression to plaque and tumor stages is 25%.

Stage T3: Presence of tumor nodules. Median survival is 4-5 years.

Stage T4: Presence of erythroderma. Median survival is 4-5 years.

Visceral involvement: Median survival is 1-2 years.

Other Prognostic Markers: Elevated levels of LDH, soluble IL-2 receptor, increased erythrocyte sedimentation rate, lymphadenopathy and peripheral blood eosinophilia are associated with poor prognosis. Progression to large cell lymphoma also shortens survival. MF patients are at increased risk of developing carcinoma of lung and colon, and B-cell non-Hodgkin lymphomas.

The image shows erythematous, scaly and eczema-like crusted patches and plaques covering the entire body of this patient with advanced MF. Fungating tumor nodules were present around the left elbow region.

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