Early MF Treatment — SCE Dermatology MCQ
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Correct answer: E — Skin-directed therapy — potent topical corticosteroids or NB-UVB phototherapy (not systemic therapy for early-stage disease)
Early-stage mycosis fungoides (stage IA-IIA) is managed with skin-directed therapies rather than systemic therapy: potent topical corticosteroids (first-line for limited patches — complete response rates approximately 60-65% for T1), NB-UVB or PUVA phototherapy (for more widespread disease), topical nitrogen mustard (Mechlorethamine), and topical Bexarotene gel. Systemic therapy (Bexarotene, Interferon-alpha, Vorinostat, romidepsin, Brentuximab vedotin, or chemotherapy) is reserved for advanced-stage disease (stage IIB+) or refractory early-stage disease. The 10-year disease-specific survival for stage IA MF exceeds 95% — aggressive systemic treatment is not warranted and does not improve survival.
Reference: BAD 2019 CTCL; EORTC-ISCL