Zackheim H S
Department of Dermatology, University of California, San Francisco.
Semin Dermatol. 1994 Sep;13(3):207-15.
A review of current therapy for cutaneous T-cell lymphoma (CTCL) (mycosis fungoides and erythrodermic CTCL) is presented. Treatments for mycosis fungoides limited to the skin include topical steroids, mechlorethamine (nitrogen mustard) and carmustine (BCNU), electron beam radiation, low-dose methotrexate, and interferon-alpha (IFN). Treatments for erythrodermic CTCL include low-dose methotrexate, IFN, extracorporeal photopheresis, and single agent or combination chemotherapy. Treatment for systemic CTCL includes IFN, single or combination chemotherapy, and combined modalities. Newer therapies are reviewed. Whereas prognosis for patients with disease limited to the skin is generally good, that for those with nodal or visceral lymphoma is mostly unfavorable. Controversial issues relating to total skin versus local treatment, prolonged maintenance versus intermittent therapy, and aggressive versus conservative treatment of early stage disease are discussed. The UCSF approach to treatment of CTCL and lymphomatoid papulosis is presented.
本文对皮肤T细胞淋巴瘤（蕈样肉芽肿和红皮病型皮肤T细胞淋巴瘤）的当前治疗方法进行了综述。局限于皮肤的蕈样肉芽肿的治疗方法包括外用类固醇、氮芥和卡莫司汀（BCNU）、电子束辐射、低剂量甲氨蝶呤和干扰素-α（IFN）。红皮病型皮肤T细胞淋巴瘤的治疗方法包括低剂量甲氨蝶呤、IFN、体外光化学疗法以及单药或联合化疗。系统性皮肤T细胞淋巴瘤的治疗方法包括IFN、单药或联合化疗以及综合治疗方式。对新型治疗方法进行了综述。局限于皮肤的疾病患者的预后通常良好，而有淋巴结或内脏淋巴瘤的患者的预后大多不佳。讨论了与全皮肤治疗与局部治疗、长期维持治疗与间歇治疗以及早期疾病的积极治疗与保守治疗相关的争议性问题。介绍了加州大学旧金山分校治疗皮肤T细胞淋巴瘤和淋巴瘤样丘疹病的方法。
