Guidelines for the management of cutaneous lymphomas (2011): A consensus statement by the Japanese Skin Cancer Society – Lymphoma Study Group

Abstract

In 2010, the first Japanese edition of guidelines for the management of cutaneous lymphoma was published jointly by the Japanese Dermatological Association (JDA) and the Japanese Skin Cancer Society (JSCS) -Lymphoma Study Group. Because the guidelines were revised in 2011 based on the most recent data, we summarized the revised guidelines in English for two reasons: (i) to inform overseas clinicians about our way of managing common types of cutaneous lymphomas such as mycosis fungoides/Sé zary syndrome; and (ii) to introduce Japanese guidelines for lymphomas peculiar to Asia, such as adult T-cell leukemia/lymphoma and extranodal natural killer/T-cell lymphoma, nasal type. References that provide scientific evidence for these guidelines have been selected by the JSCS -Lymphoma Study Group. These guidelines, together with the degrees of recommendation, have been made in the context of limited medical treatment resources, and standard medical practice within the framework of the Japanese National Health Insurance system.

Case 19-2016

“…23 The type of skin lesion is of prognostic importance, since the survival rate is lower among patients with erythroderma or tumors than among patients with only patches or plaques. 11,25,26 Although this patient's condition had partially improved with the use of interferon-α, zidovudine, and topical glucocorticoids, we subsequently added narrow-band ultraviolet B phototherapy. 24 In addition to systemic therapy for chronic or smoldering adult T-cell leukemia-lymphoma, other treatment options to consider include skindirected therapies, such as topical glucocorticoids, narrow-band ultraviolet B, psoralen-ultraviolet A, and radiation, as well as oral retinoids.…”

Cutaneous Adult T‐Cell Leukemia/Lymphoma

“…In this context, it should be underlined that, prompted by the clinicopathologic similarities to ATLL, several investigators have looked for the presence of HTLV-I DNA in cases of mycosis fungoides and Sézary syndrome. The Japanese Skin Cancer Society-Lymphoma Study Group has issued recommendations for treatment of cases with disease limited to the skin [25]. Cases with an indolent behavior and restricted to the skin may be managed with less aggressive therapeutic options such as psoralen and UV-A (PUVA) or combination schemes [5,6,23,24].…”

“…There is no convincing evidence of the involvement of The treatment of choice for ATLL is usually systemic chemotherapy, eventually followed by allogeneic stem cell transplantation. Besides PUVA, other useful options include radiation therapy, retinoids, interferon, and single-agent chemotherapy [25]. The Japanese Skin Cancer Society-Lymphoma Study Group has issued recommendations for treatment of cases with disease limited to the skin [25].…”

Management strategies for mycosis fungoides in India

“…[2] The National Comprehensive Cancer Network,[3] the European Organization for Research and Treatment of Cancer (EORTC),[4] European Society for Medical Oncology,[5] and the Japanese Skin Cancer Society – Lymphoma Study Group[6] have guidelines for management, but the rarity of patients in the Indian setting and unavailability of specific drugs make treatment not standardized in the absence of resources. There is also a paucity of data globally on randomized controlled trials in available options for therapy.…”