• Pooya Khan Mohammad Beigi


Treatment of mycosis fungoides (MF) depends on the stage of the disease. Treatment options for MF include skin-directed therapies, systemic therapies, and combination therapies. Skin-directed therapies are generally used in treating the earlier stages (I–IIA) of MF and include the following: topical agents, phototherapy, and electron beam therapy. Systemic therapies are used in advanced or refractory stages of MF. Combination therapies are those that combine skin-directed therapies and systemic therapies, or various types of systemic therapies.


Treatment Skin-directed therapies Biological therapies Systemic therapies Topical corticosteroids Mechlorethamine Carmustine Bexarotene Radiation Total skin electron beam Phototherapy Interferon Retinoids Chemotherapy Stem cell transplantation 


  1. 1.
    Olsen E, Whittaker S, Kim Y, Duvic M, Prince H, Lessin S, et al. International Society for Cutaneous Lymphomas; United States Cutaneous Lymphoma Consortium; Cutaneous Lymphoma Task Force of the European Organisation for Research and Treatment of Cancer. J Clin Oncol. 2011;29(18):2598–607.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Freiman A, Sasseville D. Treatment of mycosis fungoides: overview. J Cutan Med Surg. 2006;10(5):228–33.CrossRefPubMedGoogle Scholar
  3. 3.
    Galper SL, Smith BD, Wilson LD. Diagnosis and management of mycosis fungoides. Oncology. 2010;24(6):491.PubMedGoogle Scholar
  4. 4.
    Liu DY, Shaath T, Rajpara AN, Hanson C, Fraga G, Fischer R, et al. Safe and efficacious use of intralesional steroids for the treatment of focally resistant mycosis fungoides. J Drugs Dermatol. 2015;14(5):466–71.PubMedGoogle Scholar
  5. 5.
    Van Scott EJ, Kalmanson JD. Complete remissions of mycosis fungoides lymphoma induced by topical nitrogen mustard (HN2). Control of delayed hypersensitivity to HN2 by desensitization and by induction of specific immunologic tolerance. Cancer. 1973;32(1):18–30.CrossRefPubMedGoogle Scholar
  6. 6.
    Kim YH, Martinez G, Varghese A, Hoppe RT. Topical nitrogen mustard in the management of mycosis fungoides: update of the Stanford experience. Arch Dermatol. 2003;139(2):165–73.PubMedGoogle Scholar
  7. 7.
    Talpur R, Venkatarajan S, Duvic M. Mechlorethamine gel for the topical treatment of stage IA and IB mycosis fungoides-type cutaneous T-cell lymphoma. Expert Rev Clin Pharmacol. 2014;7(5):591–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Zackheim HS. Topical carmustine (BCNU) for patch/plaque mycosis fungoides. Seminars in dermatology. 1994;13(3):202–6.Google Scholar
  9. 9.
    Zackheim HS, Epstein EH, Crain WR. Topical carmustine (BCNU) for cutaneous t cell lymphoma: a 15-year experience in 143 patients. J Am Acad Dermatol. 1990;22(5):802–10.CrossRefPubMedGoogle Scholar
  10. 10.
    Zackheim HS. Treatment of patch-stage mycosis fungoides with topical corticosteroids. Dermatol Ther. 2003;16(4):283–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Gunderson LL, Tepper JE. Clinical radiation oncology. Philadelphia: Elsevier Health Sciences; 2015.Google Scholar
  12. 12.
    Kim EJ, Lin J, Junkins-Hopkins JM, Vittorio CC, Rook AH. Mycosis fungoides and sezary syndrome: an update. Curr Oncol Rep. 2006;8(5):376–86.CrossRefPubMedGoogle Scholar
  13. 13.
    Heald P, Mehlmauer M, Martin AG, Crowley CA, Yocum RC, Reich SD, et al. Topical bexarotene therapy for patients with refractory or persistent early-stage cutaneous T-cell lymphoma: results of the phase III clinical trial. J Am Acad Dermatol. 2003;49(5):801–15.CrossRefPubMedGoogle Scholar
  14. 14.
    Breneman D, Duvic M, Kuzel T, Yocum R, Truglia J, Stevens VJ. Phase 1 and 2 trial of bexarotene gel for skin-directed treatment of patients with cutaneous T-cell lymphoma. Arch Dermatol. 2002;138(3):325–32.CrossRefPubMedGoogle Scholar
  15. 15.
    Trautinger F. Phototherapy of mycosis fungoides. Photodermatol Photoimmunol Photomed. 2011;27(2):68–74.CrossRefPubMedGoogle Scholar
  16. 16.
    Herrmann JJ, Roenigk HH, Hurria A, Kuzel TM, Samuelson E, Rademaker AW, et al. Treatment of mycosis fungoides with photochemotherapy (PUVA): long-term follow-up. J Am Acad Dermatol. 1995;33(2):234–42.CrossRefPubMedGoogle Scholar
  17. 17.
    Rupoli S, Goteri G, Pulini S, Filosa A, Tassetti A, Offidani M, et al. Long-term experience with low-dose interferon-α and PUVA in the management of early mycosis fungoides. Eur J Haematol. 2005;75(2):136–45.CrossRefPubMedGoogle Scholar
  18. 18.
    National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: non-Hodgkin’s lymphoma version 3 (2016), Vol. 3 Fort Washington: National Comprehensive Care Network; 2016. p. 105–18.Google Scholar
  19. 19.
    Kim YH, Jensen RA, Watanabe GL, Varghese A, Hoppe RT. Clinical stage IA (limited patch and plaque) mycosis fungoides: a long-term outcome analysis. Arch Dermatol. 1996;132(11):1309–13.CrossRefPubMedGoogle Scholar
  20. 20.
    Deeths MJ, Chapman JT, Dellavalle RP, Zeng C, Aeling JL. Treatment of patch and plaque stage mycosis fungoides with imiquimod 5% cream. J Am Acad Dermatol. 2005;52(2):275–80.CrossRefPubMedGoogle Scholar
  21. 21.
    Martínez-González MC, Verea-Hernando MM, Yebra-Pimentel MT, Del Pozo J, Mazaira M, Fonseca E. Imiquimod in mycosis fungoides. Eur J Dermatol. 2008;18(2):148–52.PubMedGoogle Scholar
  22. 22.
    Duvic M, Martin AG, Kim Y, Olsen E, Wood GS, Crowley CA, et al. Phase 2 and 3 clinical trial of oral bexarotene (targretin capsules) for the treatment of refractory or persistent early-stage cutaneous T-cell lymphoma. Arch Dermatol. 2001;137(5):581–93.PubMedGoogle Scholar
  23. 23.
    Hall JC, Hall BJ. Cutaneous lymphoma: diagnosis and treatment. Shelton: PMPH; 2012.Google Scholar
  24. 24.
    Olsen EA, Bunn PA. Interferon in the treatment of cutaneous T-cell lymphoma. Hematol Oncol Clin North Am. 1995;9(5):1089–107.PubMedGoogle Scholar
  25. 25.
    Spaccarelli N, Rook AH. The use of interferons in the treatment of cutaneous T-cell lymphoma. Dermatol Clin. 2015;33(4):731–45.CrossRefPubMedGoogle Scholar
  26. 26.
    Piekarz RL, Frye R, Turner M, Wright JJ, Allen SL, Kirschbaum MH, et al. Phase II multi-institutional trial of the histone deacetylase inhibitor romidepsin as monotherapy for patients with cutaneous T-cell lymphoma. J Clin Oncol. 2009;27(32):5410–7.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Whittaker SJ, Demierre M-F, Kim EJ, Rook AH, Lerner A, Duvic M, et al. Final results from a multicenter, international, pivotal study of romidepsin in refractory cutaneous T-cell lymphoma. J Clin Oncol. 2010;28(29):4485–91.CrossRefPubMedGoogle Scholar
  28. 28.
    Tani M, Fina M, Alinari L, Stefoni V, Baccarani M, Zinzani P. Phase II trial of temozolomide in patients with pretreated cutaneous T-cell lymphoma. Haematologica. 2005;90(9):1283–4.PubMedGoogle Scholar
  29. 29.
    Duarte RF, Canals C, Onida F, Gabriel IH, Arranz R, Arcese W, et al. Allogeneic hematopoietic cell transplantation for patients with mycosis fungoides and Sézary syndrome: a retrospective analysis of the lymphoma working party of the European Group for Blood and Marrow Transplantation. J Clin Oncol. 2010;28(29):4492–9.CrossRefPubMedGoogle Scholar
  30. 30.
    Duarte RF, Boumendil A, Onida F, Gabriel I, Arranz R, Arcese W, et al. Long-term outcome of allogeneic hematopoietic cell transplantation for patients with mycosis fungoides and Sézary syndrome: a European society for blood and marrow transplantation lymphoma working party extended analysis. J Clin Oncol. 2014;32(29):3347–8.CrossRefPubMedGoogle Scholar
  31. 31.
    Mao X, Orchard G, Mitchell TJ, Oyama N, Russell‐Jones R, Vermeer MH, et al. A genomic and expression study of AP-1 in primary cutaneous T-cell lymphoma: evidence for dysregulated expression of JUNB and JUND in MF and SS. J Cutan Pathol. 2008;35(10):899–910.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Pooya Khan Mohammad Beigi
    • 1
    • 2
    • 3
  1. 1.Department of Health ManagementNew York Medical CollegeValhallaUSA
  2. 2.University of British ColumbiaVancouverCanada
  3. 3.Misdiagnosis AssociationSeattleUSA

Personalised recommendations