What are the approach considerations in the treatment of cutaneous T-cell lymphoma (CTCL)?

Updated: Aug 15, 2018
  • Author: Lauren C Pinter-Brown, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The evaluation and treatment of individuals with mycosis fungoides is usually conducted on an outpatient basis. Symptomatic treatments (eg, emollients, antipruritics) are used in combination with specific topical and systemic treatments.

Mycosis fungoides treatment selection should be based on the stage and previous treatment history. In general, topical therapies are indicated for stage I patients, and systemic therapies or combinations of topical and systemic therapies are indicated for patients with stage IIB disease or greater, or for patients with stage I mycosis fungoides who are intolerant of topical treatments or whose condition has failed to respond to such treatments. [7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17]

Sequential therapies that are stage appropriate are selected on the basis of convenience and availability to the patient, as well as on short- and long-term toxicity profiles. Therapies may also be selected based on the probability that a given patient's condition will respond and on the rapidity of onset of that response.

Clinicians should encourage the use of supportive treatments to decrease pruritus and to lubricate the skin in patients with mycosis fungoides. Nonspecific antipruritic treatments are useful and often necessary adjuncts to more specific therapies. Patients should avoid sun exposure and should remain in a cool environment.


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