Table 1.
Studies and treatment responses to topical therapies for CTCL.
| Treatment | Study | Study design | Stage | Response rate | Adverse events |
|---|---|---|---|---|---|
| Topical steroids (class I-III) | Zackheim et al. (3) | Prospective |
n = 79, IA and IB, patch and plaque |
T1: ORR 94%, CR 63%, PR 31% T2: ORR 82%, CR 25%, PR 57% |
Temporary depression of cortisol levels (n = 10), minor skin irritation, reversible skin atrophy |
| Imiquimod | Shipman et al. (4) | Case series and review |
n = 20, IA–IIB |
ORR 80%, CR 45%, PR 35% | Application site reaction, rare fatigue, flu-like symptoms |
| Resiquimod gel | Rook et al. (5) | Open label, phase 1 trial |
n = 12, IA–IIA patch, plaque, folliculotropic |
ORR 75%, CR 33%, PR 42% |
Local skin irritation, low grade fever |
| Mechlorethamine solution | Vonderheid et al. (6) | Retrospective |
n = 324, I–IV or Sezary syndrome§ |
T1 CR 80% T2 CR 62% |
Allergic contact dermatitis, increased risk of cSCC |
| Mechlorethamine solution | Ramsay et al. (7) | Retrospective |
n = 117, Stage I–III* |
60.8% CR (all stages) stage I CR 75.8% stage II CR 44.6% |
Delayed hypersensitivity reaction |
| Mechlorethamine ointment or solution | Kim et al. (8) | Retrospective |
n = 203, T1–T4§ |
ORR 83%, CR 50%, PR 33% | Irritant or allergic contact dermatitis |
| Mechlorethamine | Lessin et al. (9) | Randomized, controlled, trial |
n = 260, IA–IIA |
ORR 58.5%, CR 13.8%, PR 44.6% | Skin irritation, pruritus, contact dermatitis |
| Carmustine | Zackheim et al. (10) | Retrospective |
n = 143, IA–IVA§ |
IA: ORR 98%, CR 86%, PR 12% IB: ORR 84%, CR 47%, PR 37% |
Mild bone marrow suppression (<10%), local skin erythema and tenderness, telangiectasia |
| Bexarotene gel | Breneman et al. (11) | Phase 1/2 dose escalation trial |
n = 67, IA–IIA |
ORR 63%, CR 21%, PR 42% | Local rash, pruritus, pain, rash |
| Bexarotene gel | Heald et al. (12) | Phase III trial |
n = 50, IA–IIA |
ORR 54%, CR 10%, PR 44% | Irritant dermatitis |
| Tazarotene cream | Morin et al. (13) | Open-label, prospective study |
n = 10, IA–IIA |
CR 60% | Pruritus, burning, erythema, desquamation |
| Tazarotene gel | Apisarnthanarax et al. (14) | Open-label pilot study |
n = 19, Patch or plaque (<20% BSA) |
ORR 58%, index lesions cleared in 35% |
Skin irritation (erythema, burning, peeling) |