Problems in the management of mycosis fungoides in Nigeria

The management of Nigerian patients with cutaneous T-cell lymphoma (CTCL) is beset with various problems which are presented in this study. These problems include dearth of specialists medical personnel, shortage of radiotherapy facilities, high cost of chemotherapy drugs which an average patient cannot afford to buy. Cases of eight patients seen and managed over a 21 years period (1968-1989) were analysed. However, many CTCL cases might have been missed since we have acute shortage of medical specialists to carry out accurate diagnosis of this disease in Nigeria. The patients reviewed, received radiotherapy, and cytotoxic chemotherapy. Radiotherapy was found to be the optimum treatment for patients with stages I and II CTCL, who in this study had recurrence free periods of 30 to 60 months post radiotherapy. The authors recommend systemic cytotoxic chemotherapy and local radiotherapy for patients with late stages of CTCL as mainstay of treatment.