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GEORGE J.HRUZAMDDEE ANNAGLASERMDELAINESIEGFRIEDMD
A 52-year-old woman with cutaneous T-cell lymphoma (CTCL) presented to the dermatology clinic for treatment. She had a more than 10-year history of episodic dry, itchy patches over her trunk and extremities. Previous biopsy specimens obtained from the patches revealed histopathologic changes typical of CTCL. Treatment with a number of topical steroid preparations and topical nitrogen mustard and carmustine had been ineffective. On physical examination, she had 2 clinically similar, well-demarcated patches with mild erythema and scale involving less than 10% of her total body surface area (stage IA). She had no evidence of systemic involvement.
Although patients with stage IA CTLC (less than 10% total skin surface involvement without lymph node or visceral metastases) experience long-term survival similar to that of a matched control population, approximately 10% progress to more advanced disease and 50% experience recurrence of disease despite appropriate therapy.1 The current standard therapies, such as topical steroids or chemotherapy, and γ irradiation are associated with adverse effects, including atrophy, telangiectases, allergic contact or irritant dermatitis, and radiation dermatitis. Also, in any stage of disease, patients can experience prominent pruritus and physical disfigurement. Therefore, alternative approaches to the treatment of CTCL are desired. Our purpose was to determine the efficacy of 5% imiquimod cream in comparison with placebo in the treatment of stage IA CTCL.
Suchin KR, Junkins-Hopkins JM, Rook AH, Hospital of the University of Pennsylvania, Philadelphia. Treatment of Stage IA Cutaneous T-Cell Lymphoma With Topical Application of the Immune Response Modifier Imiquimod. Arch Dermatol. 2002;138(9):1137–1139. doi:10.1001/archderm.138.9.1137
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