Mycosis Fungoides - Een Diepgaande Verkenning van Deze Huidaandoening

Skin-Directed Therapies

In most patients with MF, the lymphoma cells are primarily limited to the skin, and one can have excellent and long-lasting responses with treatments directed at the skin, or “skin directed therapy”. Because treatment is directed just at the skin, the toxicity of these treatments is low. Examples of skin directed therapies are creams, ointments, or gels that are applied to the skin, such as topical steroids, topical nitrogen mustard, retinoids, and immune stimulating creams (imiquimod). Ultraviolet light (“medical tanning”) and radiation therapy are also types of skin directed therapy.

“Systemic therapy” refers to any treatment that, after absorption, reaches the bloodstream and is therefore distributed across the body “system.” Any drug that is taken by mouth, given as a suppository, injected under the skin, taken under the tongue, or directly infused through a blood vessel will eventually reach all body organs and tissues (including the skin), with the exception of the brain, which by design is protected by a specific “barrier.” Systemic therapies are used in MF when skin directed therapies aren’t working well enough, or are too difficult to apply, or the disease is advanced. Systemic therapies may be used alone or in combination, and are often used together with skin directed therapies (for example using a pill to make you more sensitive to ultraviolet light therapy). Nearly all of the systemic therapies used in MF are considered “targeted” drugs, which means that they work in different ways than “traditional” or “standard” chemotherapy.

There are many examples of systemic therapies that are used in MF, including pills such as bexarotene, methotrexate and vorinostat, infusional therapies like pralatrextate and romidepsin, and immunotherapies like pembroluzimab. Traditional or standard chemotherapy, which would be used for other blood cancers, is only rarely used in MF because of severe side effects and a high rate of MF returning after treatment.

Notes

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

This research was published first at International Journal of Medicine in Developing Countries Received: 07 November 2020 | Accepted: 18 November 2020. This research was published first at International Journal of Medicine in Developing Countries Received: 07 November 2020 | Accepted: 18 November 2020

Topical treatments

• topical corticosteroids
• topical chemotherapy
• bexarotene, a type of retinoid

These treatments aim to cure or improve mycosis fungoides. They include:

• Photodynamic therapy: This therapy uses a drug and a laser light to kill cancer cells. The light activates the drug and only affects cancer cells. An example is psoralen and ultraviolet A (PUVA) therapy, which uses the drug psoralen with UVA light.
• Radiation therapy:Radiation therapy uses high energy X-rays or other radiation to kill cancer cells or slow their growth. Doctors may also use it as palliative therapy to relieve symptoms.
• Extracorporeal photopheresis: This treatment involves drawing blood from the body and sensitizing T cells to UVA light. This allows doctors to damage the cancerous cells with UVA light. Doctors then put the blood back into the patient’s body.

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