Suggested Guidelines for the Treatment of Mycosis Fungoides in Countries with Limited Resources
The treatment options for mycosis fungoides (MF) have been expanding but unfortunately many of the currently used treatment modalities are unavailable in Egypt and other African/Arab countries. In addition, there is a lack of consensus on the treatment of hypopigmented MF (HMF), which is a frequentl...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Hindawi Limited
2023-01-01
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| Series: | Dermatology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2023/1360740 |
| _version_ | 1811165467007516672 |
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| author | Mona Abdel-Halim Ibrahim Nada Eltayeb Mirna Michel Ibrahim Ahmed Nassar Maged Daruish Maha El-Zimaity Mahmoud El-Lithy Ahmed Mostafa Amal El-Afifi Haitham Abdelbary Mahira Hamdy El-Sayed |
| author_facet | Mona Abdel-Halim Ibrahim Nada Eltayeb Mirna Michel Ibrahim Ahmed Nassar Maged Daruish Maha El-Zimaity Mahmoud El-Lithy Ahmed Mostafa Amal El-Afifi Haitham Abdelbary Mahira Hamdy El-Sayed |
| author_sort | Mona Abdel-Halim Ibrahim |
| collection | DOAJ |
| description | The treatment options for mycosis fungoides (MF) have been expanding but unfortunately many of the currently used treatment modalities are unavailable in Egypt and other African/Arab countries. In addition, there is a lack of consensus on the treatment of hypopigmented MF (HMF), which is a frequently encountered variant in our population. We aimed to develop regional treatment guidelines based on the international guidelines but modified to encompass the restricted treatment availability and our institutional experience. Special attention was also given to studies conducted on patients with skin phototype (III-IV). Treatment algorithm was formulated at Ain-Shams cutaneous lymphoma clinic through the collaboration of dermatologists, haematologists, and oncologists. Level of evidence is specified for each treatment option. For HMF, phototherapy is recommended as a first line treatment, while low-dose methotrexate is considered a second line. For early classical MF, we recommend Psoralen-ultraviolet A (PUVA), which is a well-tolerated treatment option in dark phenotype. Addition of either retinoic acid receptor (RAR) agonist and/or methotrexate is recommended as a second line. Total skin electron beam (TSEB) is considered a third-line option. For advanced stage, PUVA plus RAR agonist and/or methotrexate is recommended as first line, TSEB or monochemotherapy is considered a second line option. Polychemotherapy is regarded as a final option. All patients with complete response (CR) enter a maintenance and follow-up schedule. We suggest a practical algorithm for the treatment of MF for patients with dark phenotype living in countries with limited resources. |
| first_indexed | 2024-04-10T15:37:35Z |
| format | Article |
| id | doaj.art-3cc74b88da6d4187aa415f547a961e8b |
| institution | Directory Open Access Journal |
| issn | 1687-6113 |
| language | English |
| last_indexed | 2024-04-10T15:37:35Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi Limited |
| record_format | Article |
| series | Dermatology Research and Practice |
| spelling | doaj.art-3cc74b88da6d4187aa415f547a961e8b2023-02-13T01:08:39ZengHindawi LimitedDermatology Research and Practice1687-61132023-01-01202310.1155/2023/1360740Suggested Guidelines for the Treatment of Mycosis Fungoides in Countries with Limited ResourcesMona Abdel-Halim Ibrahim0Nada Eltayeb1Mirna Michel Ibrahim2Ahmed Nassar3Maged Daruish4Maha El-Zimaity5Mahmoud El-Lithy6Ahmed Mostafa7Amal El-Afifi8Haitham Abdelbary9Mahira Hamdy El-Sayed10Dermatology DepartmentDermatology DepartmentDermatology DepartmentDermatology DepartmentDepartment of DermatopathologyHematology DepartmentOncology DepartmentOncology DepartmentHematology DepartmentHematology DepartmentDermatology DepartmentThe treatment options for mycosis fungoides (MF) have been expanding but unfortunately many of the currently used treatment modalities are unavailable in Egypt and other African/Arab countries. In addition, there is a lack of consensus on the treatment of hypopigmented MF (HMF), which is a frequently encountered variant in our population. We aimed to develop regional treatment guidelines based on the international guidelines but modified to encompass the restricted treatment availability and our institutional experience. Special attention was also given to studies conducted on patients with skin phototype (III-IV). Treatment algorithm was formulated at Ain-Shams cutaneous lymphoma clinic through the collaboration of dermatologists, haematologists, and oncologists. Level of evidence is specified for each treatment option. For HMF, phototherapy is recommended as a first line treatment, while low-dose methotrexate is considered a second line. For early classical MF, we recommend Psoralen-ultraviolet A (PUVA), which is a well-tolerated treatment option in dark phenotype. Addition of either retinoic acid receptor (RAR) agonist and/or methotrexate is recommended as a second line. Total skin electron beam (TSEB) is considered a third-line option. For advanced stage, PUVA plus RAR agonist and/or methotrexate is recommended as first line, TSEB or monochemotherapy is considered a second line option. Polychemotherapy is regarded as a final option. All patients with complete response (CR) enter a maintenance and follow-up schedule. We suggest a practical algorithm for the treatment of MF for patients with dark phenotype living in countries with limited resources.http://dx.doi.org/10.1155/2023/1360740 |
| spellingShingle | Mona Abdel-Halim Ibrahim Nada Eltayeb Mirna Michel Ibrahim Ahmed Nassar Maged Daruish Maha El-Zimaity Mahmoud El-Lithy Ahmed Mostafa Amal El-Afifi Haitham Abdelbary Mahira Hamdy El-Sayed Suggested Guidelines for the Treatment of Mycosis Fungoides in Countries with Limited Resources Dermatology Research and Practice |
| title | Suggested Guidelines for the Treatment of Mycosis Fungoides in Countries with Limited Resources |
| title_full | Suggested Guidelines for the Treatment of Mycosis Fungoides in Countries with Limited Resources |
| title_fullStr | Suggested Guidelines for the Treatment of Mycosis Fungoides in Countries with Limited Resources |
| title_full_unstemmed | Suggested Guidelines for the Treatment of Mycosis Fungoides in Countries with Limited Resources |
| title_short | Suggested Guidelines for the Treatment of Mycosis Fungoides in Countries with Limited Resources |
| title_sort | suggested guidelines for the treatment of mycosis fungoides in countries with limited resources |
| url | http://dx.doi.org/10.1155/2023/1360740 |
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