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Mycosis Fungoides — SCE Dermatology MCQ

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HardSkin CancerMycosis FungoidesSCE Dermatology

A 50-year-old man with known CTCL (mycosis fungoides, large cell transformation) develops rapidly enlarging tumour nodules. Biopsy shows >25% large cells (CD30 positive). What does CD30 positivity in this context indicate?

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Correct answer: E — Potential eligibility for Brentuximab vedotin (anti-CD30 antibody-drug conjugate)

CD30 positivity in transformed mycosis fungoides has therapeutic implications — Brentuximab vedotin is an anti-CD30 antibody-drug conjugate (ADC) approved for CD30-expressing CTCL including transformed MF. While primary cutaneous CD30+ lymphoproliferative disorders (lymphomatoid papulosis, primary cutaneous ALCL) have excellent prognosis, CD30 positivity in transformed MF indicates a different clinical context (aggressive large-cell transformation with poorer prognosis). NICE has approved Brentuximab vedotin for CD30-positive CTCL after at least one prior systemic therapy.

Reference: BAD 2019 CTCL Guidelines; NICE TA577 Brentuximab