Sanches José Antonio, Cury-Martins Jade, Abreu Rodrigo Martins, Miyashiro Denis, Pereira Juliana
Dermatology Clinic Division, Faculty of Medicine, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil.
Dermatology Clinic Division, Faculty of Medicine, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil.
An Bras Dermatol. 2021 Jul-Aug;96(4):458-471. doi: 10.1016/j.abd.2020.12.007. Epub 2021 May 28.
Cutaneous T-cell lymphomas are a heterogeneous group of lymphoproliferative disorders, characterized by infiltration of the skin by mature malignant T cells. Mycosis fungoides is the most common form of cutaneous T-cell lymphoma, accounting for more than 60% of cases. Mycosis fungoides in the early-stage is generally an indolent disease, progressing slowly from some patches or plaques to more widespread skin involvement. However, 20% to 25% of patients progress to advanced stages, with the development of skin tumors, extracutaneous spread and poor prognosis. Treatment modalities can be divided into two groups: skin-directed therapies and systemic therapies. Therapies targeting the skin include topical agents, phototherapy and radiotherapy. Systemic therapies include biological response modifiers, immunotherapies and chemotherapeutic agents. For early-stage mycosis fungoides, skin-directed therapies are preferred, to control the disease, improve symptoms and quality of life. When refractory or in advanced-stage disease, systemic treatment is necessary. In this article, the authors present a compilation of current treatment options for mycosis fungoides and Sézary syndrome.
皮肤T细胞淋巴瘤是一组异质性的淋巴增殖性疾病,其特征是成熟的恶性T细胞浸润皮肤。蕈样肉芽肿是皮肤T细胞淋巴瘤最常见的形式,占病例的60%以上。早期蕈样肉芽肿通常是一种惰性疾病,从一些斑片或斑块缓慢进展至更广泛的皮肤受累。然而,20%至25%的患者会进展至晚期,出现皮肤肿瘤、皮肤外扩散且预后不良。治疗方式可分为两类:皮肤定向治疗和全身治疗。针对皮肤的治疗包括外用药物、光疗和放疗。全身治疗包括生物反应调节剂、免疫疗法和化疗药物。对于早期蕈样肉芽肿,首选皮肤定向治疗,以控制疾病、改善症状和生活质量。当疾病难治或处于晚期时,则需要进行全身治疗。在本文中,作者介绍了蕈样肉芽肿和塞扎里综合征目前的治疗选择汇总。