Treatment of cutaneous T-cell lymphoma

Intensive treatment of cutaneous T-cell lymphoma with modalities directed only at skin manifestations appears to cure up to 40 per cent of patients with early, limited skin involvement. For patients with widely disseminated skin lesions, the dermatologist often must choose a treatment regimen with both cutaneous and systemic effects in order to provide effective long-term control. Although vigorous combined-modality therapy results in improved disease-free survival intervals, it also has significant associated morbidity. When compared with less intensive treatment regimens, it is not clear at this time whether such combined-modality therapy improves either the cure rate or overall survival intervals of patients with early disease. For this reason, the authors recommend a conservative treatment program initially for most patients unless there is clinical evidence that the patient has biologically aggressive disease.