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Abstract
Skin directed therapies (SDTs) serve important roles in the treatment of early stage cutaneous T-cell lymphoma (CTCL)/mycosis fungoides (MF), as well as managing symptoms and improving quality of life of all stages. There are now numerous options for topical therapies that demonstrate high response rates, particularly in early/limited MF. Phototherapy retains an important role in treating MF, with increasing data supporting efficacy and long-term safety of both UVB and PUVA as well as some newer/targeted methodologies. Radiation therapy, including localized radiation and total skin electron beam therapy, continues to be a cornerstone of therapy for all stages of MF.
Highlights
Skin directed therapies (SDTs) in cutaneous T-cell lymphoma (CTCL)/mycosis fungoides (MF) serve important roles in treating disease, and in treating symptoms
Most SDT are appropriate for patients with any stage MF, topical preparations may be most practical for those with limited skin body surface area involvement compared to patients with generalized skin involvement
The phase 2 trial leading to FDA approval of topical mechlorethamine gel (Valchlor) included 260 stage in patients with T1 (IA) to IIA MF patients treated with 0.02% gel daily for up to 12 months
Summary
Skin directed therapies (SDTs) in cutaneous T-cell lymphoma (CTCL)/mycosis fungoides (MF) serve important roles in treating disease, and in treating symptoms. SDTs can be used to cure CTCL in some patients with limited or early stage MF (stage 1A, 1B), they are most often used with palliative intent at all stages [1], with adjunct roles for both treatment and symptom management in more advanced MF, managing pruritus and maintaining the skin barrier. Most SDT are appropriate for patients with any stage MF, topical preparations may be most practical (and utilized with the highest compliance and best response) for those with limited skin body surface area involvement compared to patients with generalized skin involvement.
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