Those with T2, T3 and T4 disease had survival rates of 12.1 years, 2.9 years and 3.6 years, respectively. Patients with T1 disease are at risk of progression to higher stages. Treatment may prevent or retard disease progression. The differential diagnosis is outlined in Table 2. Treatment The slow evolution of CTCL, wide variability of progression and insidious extracutaneous spread make a specific choice of treatment difficult in many patients.
Topical therapies are desirable in patients with limited skin involvement.
When cutaneous T-cell lymphoma is limited to the skin, the prognosis is good, with a mean survival of over 30 years. Patients with more extensive disease require systemic therapy to prolong survival. Infection is the usual cause of mortality in patients who die of this disease. The normal T-cell component is eliminated as the disease progresses, and patients become immunosuppressed, not unlike patients with advanced acquired immunodeficiency sydrome. Reprints are not available from the authors.