Multidisciplinary Cutaneous Lymphoma Group

Educational Resources

Mycosis Fungoides

Lymphomas are cancers of the lymphoid system, and mycosis fungoides is a rare type of lymphoma, which affects the skin. MF was first described by a French physician, Alibert , in 1806. It has many different appearances, including scaly thin red patches of skin, raised and thick skin changes, tumor or nodular skin changes, and/or erythroderma . Approximately 1000 new cases are diagnosed in the U.S. each year. The average age at the time of diagnosis is approximately 55, although cases have been reported in infants and people older than 80.

In MF, the T-cells accumulate abnormally in the skin, growing excessively and uncontrolled. Interactions of these malignant lymphocytes with other cells in the skin cause the visible skin changes. The malignant T-cells may also circulate in the blood, as in Sezary Syndrome (SS), accumulate in lymph nodes, or affect internal organs. More »



Topical Mustargen

Manufactured by Merck & Co., topical nitrogen mustard (mechlorethamine), also called Mustargen™ or NM, is a commonly used topical chemotherapy agent that is prescribed to patients with mycosis fungoides (MF). It is efficient in treating patches or plaques. Since its discovery of use in 1959, NM has been the most widely used topical (applied to the skin) chemotherapy in treating MF. Topical NM may be used as an aqueous (water) or ointment based preparation (mixed with Aquaphor), though the results are the same. It may also be used in propylene glycol, though the effectiveness of this method in comparison to the other two methods are still not completely known. More »



Extracorporeal Photopheresis

Photopheresis (ECP) is a type of medical therapy that can be used in treating patients with problems associated with cutaneous (skin) T-cell lymphoma (CTCL) such as mycosis fungoides (MF) or Sezary syndrome. ECP is also used to treat conditions including graft-versus-host disease (GVHD) and organ transplant rejection. It was developed by THERAKOS©, a Johnson & Johnson company. Photopheresis treatments at Stanford Medical Center are given at the Cancer Center in the Apheresis Area. More »



Interferon alfa-2B

Interferon alfa-2b (brand name Intron® A) is a type of medical immune-stimulatory therapy that can be used to treat patients with cutaneous lymphoma-in particular mycosis fungoides. It is used to treat widespread patches, plaques, or tumorous skin lesions, and it is commonly used in combination with other therapies. Interferon alfa-2b is a water-soluble protein that is normally produced by the body but can synthetically be produced by recombinant DNA techniques (bacterial fermentation of an Escherichia coli strain containing an interferon alfa-2b gene from human white blood cells). More »



Targretin

Targretin® (bexarotene) is a retinoid medication that is used as a treatment for cutaneous T-cell lymphoma (CTCL), and is made by Eisai® Pharmaceuticals Incorporated. Bexarotene is a type of subclass of retinoids that selectively activate retinoid X receptors. It can be taken as capsules orally or may also be applied as a topical gel. The topical gel is usually prescribed to patients with specific, localized plaques or tumors and the oral Targretin® is prescribed to patients who have generalized skin lesions all throughout the body. More »



Managing Itch

Itchiness, also known as pruritus, can range in degree from just a minor annoyance from a mosquito bite to an overwhelming, torturous sensation that can even derange a person completely. Unfortunately, the itch-scratch cycle (the cycle of which an itch demands a scratch and the scratch further deepens an itch) is far from being understood in the aspects of neurophysiology. Until recently, most researchers believed that the itch sensation traveled along the save nerve pathways to the brain as pain. However, this theory did not seem very likely. One team of researchers found that under hypnosis, a fully anesthetized arm could still feel itch under stimulation (3). On top of this, morphine and other opiate-based painkillers actually induce intense itchiness while it blocks pain receptors. Not too long ago, a team of researchers discovered a group of slow-conducting, open-ended, unmyelinated nerve cells that carry the sensation of itch down the spinal cord to the brain, triggering a response. More »

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