Boh Erin, Kuraitis Drew, Jacobson Abby, Sikes Martha
Tulane University, 1430 Tulane Ave, New Orleans, LA, 70112, USA.
Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
Dermatol Ther (Heidelb). 2023 Mar;13(3):835-842. doi: 10.1007/s13555-023-00895-2. Epub 2023 Feb 2.
Cutaneous T-cell lymphoma (CTCL) is a rare, heterogeneous group of non-Hodgkin lymphomas characterized by various clinical, molecular, and histopathologic features of the skin. Variants of CTCL share many clinical features with common inflammatory skin diseases such as atopic dermatitis and psoriasis, making accurate and early diagnosis challenging in clinical settings. Inappropriate treatment or a delay in diagnosis can lead to increased morbidity and mortality. Here, we report findings from an online survey that investigated dermatology community practice, knowledge, and education surrounding CTCL.
An electronic survey of ten questions was developed and approved by physician experts in CTCL to assess experiences in diagnosing and treating CTCL among healthcare providers (HCPs). The survey was deployed to 10,600 US dermatology HCPs, including medical doctors (MDs), doctors of osteopathic medicine (DOs), nurse practitioners (NPs), and physician assistants (PAs) and excluding HCPs associated with CTCL centers of excellence.
Among 44 HCPs who responded and were eligible for inclusion, 82% had diagnosed between one and ten CTCL cases in the last 5 years. Most respondents (91%) reported that they include CTCL in their differential diagnoses after patients do not respond to treatment of more common conditions. Patients with CTCL were frequently diagnosed with other inflammatory dermatoses-most commonly dermatitis and psoriasis-before a CTCL diagnosis, and many were treated with ineffective therapies for years. The most common length of time before a CTCL diagnosis was made was between 1 and 3 years, though 16% of HCPs reported that patients were treated for other diseases or skin conditions for ≥ 5 years. Two-thirds of HCPs agreed that further education surrounding CTCL is needed.
Given the infrequency of CTCL and its similar presentation to other common dermatologic conditions, increased education of CTCL is needed in the dermatology community to improve patient outcomes.
皮肤T细胞淋巴瘤（CTCL）是一组罕见的、异质性的非霍奇金淋巴瘤，其特征为皮肤具有各种临床、分子和组织病理学特征。CTCL的变体与特应性皮炎和银屑病等常见炎症性皮肤病具有许多共同的临床特征，这使得在临床环境中进行准确和早期诊断具有挑战性。不适当的治疗或诊断延迟会导致发病率和死亡率增加。在此，我们报告一项在线调查的结果，该调查研究了皮肤科领域围绕CTCL的临床实践、知识和教育情况。
在CTCL领域的医师专家制定并批准了一项包含十个问题的电子调查问卷，以评估医疗服务提供者（HCP）对CTCL的诊断和治疗经验。该调查问卷被发放给10600名美国皮肤科HCP，包括医学博士（MD）、骨病医学博士（DO）、执业护士（NP）和医师助理（PA），并排除了与CTCL卓越中心相关的HCP。
在44名回复且符合纳入条件的HCP中，82%在过去5年中诊断出1至10例CTCL病例。大多数受访者（91%）报告称，在患者对更常见疾病的治疗无反应后，他们才将CTCL纳入鉴别诊断。CTCL患者在被诊断为CTCL之前，经常被诊断为其他炎症性皮肤病，最常见的是皮炎和银屑病，而且许多患者多年来一直接受无效治疗。在确诊CTCL之前，最常见的时间长度为1至3年，不过16%的HCP报告称，患者因其他疾病或皮肤状况接受了≥5年的治疗。三分之二的HCP同意需要围绕CTCL开展进一步教育。
鉴于CTCL发病率低且其表现与其他常见皮肤病相似，皮肤科领域需要加强对CTCL的教育，以改善患者预后。
