Figure 1.

Alterations in the development of malignant CTCL cells of mycosis fungoides and Sézary syndrome. Activated skin-homing T cells in the skin are met with mutagenic insults, and along with changes in the aging immune system, result in T cell apoptosis resistance and cutaneous persistence. Subsequent genomic alterations including the loss of chromosomal structure controls further promote proliferation and selection of genomic copy number alterations (GCNAs) and single nucleotide variants (SNVs) that promote malignant CTCL behavior. (figure created with biorender.com)