DEAR DR. GOTT:
You have written about itchy skin several times in the past and on occasion indicate that it might be due to serious condition. Invariably, I get excited thinking, “Oh, yes, he’s finally going to talk about mycosis fungoides/Sezary syndrome!” Each time, however, is a let down. Let me share my experience.
My father suffered unnecessarily, I think, because he was misdiagnosed for several years with psoriasis when it was actually Sezary syndrome. Mycosis fungoides and Sezary syndrome are two forms of cutaneous T-cell lymphomas (cancer).
I believe my father died because a surgeon operated on his back without realizing how fragile his skin was from the Sezary syndrome. I think that a lack of information created a situation that could have been handled differently, and perhaps, my father would still be here.
I am sure that there are actual cases of psoriasis but I would hope that if there are patients with red, scaly, itchy skin that fails to respond to treatment, they would at least investigate these life threatening diseases.
DEAR READER:
Mycosis fungoides in a type lymphocyte cancer (lymphoma) that affects the skin. Lymphocytes are infection-fighting white blood cells. T-cell lymphocytes are specialized versions which help the body’s immune system. This is a relatively rare type of cancer with only about 1000 new cases diagnosed per year in the United States. It is more common in African-Americans than Caucasians and in more men than women. It usually presents at around age 50, but is occasionally seen in children and adolescents. The cause is unknown.
Mycosis fungoides ordinarily develops slowly over many years. In fact, because of non-specific laboratory testing of early lesions, it is often misdiagnosed as a benign ailment. The average time span between onset of symptoms and proper diagnosis is about six years.
In its early stages, the skin may become itchy and develop dry, dark patches, similar to those associated with psoriasis or eczema. As the disease progresses, tumors may develop. As more of the skin becomes affected, intense itching, scaling, thickening of the skin and more can develop. Skin infections can become more frequent due to cuts and tears as a result of scratching.
Mycosis fungoides is a chronic condition that, unless caught very early, is often fatal. Depending on the stage of disease at diagnosis, life expectancy can range from normal (for early cases) to as little at one year (for advanced cases). It is important to be under the care of an oncologist once properly diagnosed. For those who have been diagnosed with conditions such as eczema or psoriasis that fail to respond to appropriate medications, ask about further testing to determine if there is, in fact, a different cause.
Thank you for writing to remind me about this rare, but very serious skin cancer.
To give you related information, I am sending you a copy of my Health Report “Psoriasis and Eczema”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
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