Skin directed therapy for mycosis fungoides: a review.

Mycosis fungoides (MF) is a rare neoplasm of epidermotropic CD4+ lymphocytes and represents a majority of all cutaneous T cell lymphomas. Early stage MF is limited to cutaneous patches and plaques that can be treated with topical modalities with high response rates. More aggressive systemic treatment of early disease does not alter survival or cure the disease and could accelerate progression by causing immunosuppression. Topical corticosteroids, mechlorethamine, and carmustine have been the mainstays of early treatment of MF for more than 30 years. More recently, topical formulations of retinoids, novel rexinoids, methotrexate, immunomodulators, and photodynamic compounds have been investigated for their potential roles in treating early ME The future of topical treatments for MF is promising both as primary and adjunctive therapy.