The most frequent kind of cutaneous T-cell lymphoma is mycosis fungoides. Mycosis fungoides can appear in a variety of ways, although often presented to physicians at an early stage and with a slow progression. 

The National Comprehensive Cancer Network (NCCN) has developed therapy and staging recommendations for mycosis fungoides. Although, these guidelines do not give particular treatment regimens for lesions in challenging sites or those that are resistant to suggested treatments. As a result, recommendations based on practices and judgments made in the multidisciplinary cutaneous lymphoma clinic at Thomas Jefferson University’s Sidney Kimmel Cancer Center, Philadelphia, PA, USA, are offered here. Lesions in places such as the face and intertriginous zones are sometimes difficult to treat since first-line medications are commonly ineffective, and the sites increase the potential of adverse effects. Furthermore, lesions in the bathing suit distribution are frequently unresponsive to first-line therapy for unknown reasons.


Finally, while being well-described, erythroderma related to mycosis fungoides is difficult to cure, with the debate around alternative techniques of treatment. The emphasis is now on challenging clinical circumstances, evaluating the suggested treatment as outlined in the NCCN recommendations, and alternate treatments for lesions that are either difficult to treat due to location or are resistant to the prescribed therapy. Providers can treat patients with more difficult diseases more effectively if gaps in recommendations are addressed.