B18. Cutaneous T-cell lymphomas

Mycosis fungoides
- CD4+ T-cell lymphoma
- Progresses slowly
- Stage I – patch stage
  - Scaly, pruritic, well-demarcated patches
- Stage II – plaque stage
  - Scaly, pruritic, well-demarcated plaques
  - Large
- Stage III – tumor stage
  - Dome-shaped purple or red nodules
- Treatment
  - Topical steroids
  - Topical chemo
  - Phototherapy
  - Biological therapy
  - Systemic chemo
Sézary syndrome
- Can develop from mycosis fungoides or de novo
- Clinical triad
  - Systemic skin lesions
    - Erythroderma
    - Palmar and plantar hyperkeratosis
    - Pruritus
  - Generalized lymphadenopathy
  - Atypical T-cells in blood
- Treatment
  - Extracorporal photopheresis
  - Phototherapy
  - Chemotherapy
Adult cutaneous T-cell leukaemia/lymphoma
- HTLV-I associated
- Similar lesions to mycosis fungoides