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Fungoid mycosis

Three main points of view pass an opinion on essence of fungoid mycosis now. Fungoid mycosis is: 1) inflammatory process on the essence from beginning to end; 2) inflammatory process in early stages with transformation in a neoplasm at the end of a disease; 3) malignant process from the very beginning. Irrespective of treatment of a pathogeny of a disease almost all researchers agree that the end-stage of fungoid mycosis represents the real blastomatous process.

Both floors have fungoid mycosis, men are slightly more often. The disease meets mainly at the age of 40 — 60.
In recent years cases of registration of fungoid mycosis became frequent, perhaps, due to diagnosis improvement, especially in early stages of a disease.

Clinic of fungoid mycosis

Most often Aliber's form — Bazena who is subdivided into three stages meets: erythematic, blyashechny (infiltrative) and tumoral. In an erythematic stage there are flesh-colored or cyanotic-crimson spots with an easy grayish peeling which are followed by very severe itch which can precede rashes. In the beginning rashes are located on a trunk, extensor surfaces of extremities, and then, merging, can take considerable sites of an integument. This stage quite often has the Polymorphic picture and can remind many dermatosis (a parapsoriasis, the prurigo, red flat deprive, a herpetiform dermatosis, etc.) . One authors consider that a number of a dermatosis can be transformed to fungoid mycosis. Others believe that the erythematic stage of fungoid mycosis can clinically remind eczema, psoriasis and other dermatosis. Imperceptibly, through various terms (from several months to several decades), there is a blyashechny (infiltrative) stage in which there are an infiltration and consolidation of spots, their growth on the periphery; the itch becomes even more painful. Infiltrative spots gain more saturated brick-red, crimson color, reminding orange crusts. As a result of regress of plaques figures in the form of garlands, arches, rings are formed. A number of authors call the first two stages premikozy, or the zremikotichesky period. The last stage — a stage of tumors at which elements reach the sizes of orange and more is more characteristic and have reddish-yellowish or reddish and cyanotic color. These "tomatoes" can meet along with infiltrates of a blyashechny stage.

In all three stages note a hyperadenosis. In the beginning inguinal and femoral gimfatichesky nodes are involved in process.
Meet Vidal's form much less often — Brock, at sotory there are no "premikotichesky" periods and on probably shchorovy skin tumors, and an erythrodermic form of Gallopo — Benye of which development of a universal exfoliative erythrosis is characteristic are suddenly formed (hyperemic, shchfiltrirovanny skin is covered with macrolaminar scales).

Histopathology

In an erythematic stage of fungoid mycosis find usual inflammatory infiltrate; only sometimes in it there is a small amount of reticular macrophages. In a blyashechny stage infiltrate is located mainly in papillary part of a derma. The considerable maintenance in it of eosinophils and existence of peculiar, atypical reticular macrophages ("mycotic" letka), and also Potriye's "microabscesses" are characteristic (small accumulations in a malpigiyevy node of lymphocytes and histiocytes). In a tumoral stage the quantity of reticular, "mycotic" macrophages increases and infiltrate deeply gets into a hypodermic fatty tissue.

At pathoanatomical research of patients with fungoid mycosis in internals (in lungs, a stomach, a liver, etc.) nodes with histologic changes, identical changes in skin are found.

Forecast

At modern methods of treatment of fungoid mycosis in most cases it is possible to achieve long remission. Whether in these cases the lethal outcome can be caused by complications of intercurrent diseases. In a tumoral stage the forecast already.

Treatment of fungoid mycosis

There is an opinion that at the initial, favorably proceeding forms of fungoid mycosis it is reasonable to appoint conservative fortifying treatment (vitamins of group B, vitamin C) and outwardly steroid ointments. Also sanatorium treatment is shown.

In more expressed stages of an illness it is more preferable to appoint a combination therapy: cytostatics, antineoplastic antibiotics. It is reasonable to combine Prospidinum with corticosteroids.
In these cases the effect comes quicker at smaller doses of drugs in this connection the number of by-effects and complications decreases.
In a tumoral stage of fungoid mycosis apply a roentgenotherapy. Outwardly appoint the funds allocated for reduction of an itch, including corticosteroid ointments.

 
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