中国罕见病联盟皮肤罕见病专业委员会, 国家皮肤与免疫疾病临床医学研究中心, 中国医疗保健国际交流促进会皮肤科分会. 中国蕈样肉芽肿诊疗及管理专家指南[J]. 罕见病研究, 2023, 2(2): 191-209. DOI: 10.12376/j.issn.2097-0501.2023.02.008
引用本文: 中国罕见病联盟皮肤罕见病专业委员会, 国家皮肤与免疫疾病临床医学研究中心, 中国医疗保健国际交流促进会皮肤科分会. 中国蕈样肉芽肿诊疗及管理专家指南[J]. 罕见病研究, 2023, 2(2): 191-209. DOI: 10.12376/j.issn.2097-0501.2023.02.008
Rare Skin Disease Committee of China Alliance for Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Dermatology Branch of China International Exchange and Promotion Association for Medical and Health Care. Expert Guidelines for the Diagnosis, Treatment, and Management of Mycosis Fungoides in China[J]. Journal of Rare Diseases, 2023, 2(2): 191-209. DOI: 10.12376/j.issn.2097-0501.2023.02.008
Citation: Rare Skin Disease Committee of China Alliance for Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Dermatology Branch of China International Exchange and Promotion Association for Medical and Health Care. Expert Guidelines for the Diagnosis, Treatment, and Management of Mycosis Fungoides in China[J]. Journal of Rare Diseases, 2023, 2(2): 191-209. DOI: 10.12376/j.issn.2097-0501.2023.02.008
  • 摘要: 蕈样肉芽肿(MF)是原发于记忆性辅助T细胞的皮肤淋巴瘤。典型的MF皮损具有典型的3期表现,早期为斑片,逐渐形成浸润性斑块,晚期可出现肿瘤、红皮病,也可能累及淋巴结和其他脏器,自然病程可达数十年。MF早期诊断困难,需要定期随访、重复活检,并结合临床表现、组织病理、免疫表型、分子生物学进行综合判断。MF患者的治疗应根据分期决定,早期MF可选择外用药物、光疗、放疗等皮肤定向治疗,晚期MF或复发难治性早期MF需进行系统治疗,系统治疗均可联合皮肤定向治疗以缓解症状。多学科诊疗模式对于MF患者的管理十分重要,在制订治疗方案时应由多学科诊疗团队对患者进行整体评估,充分权衡可能的获益、患者耐受性及治疗副反应,以延缓疾病进展,改善患者生活质量。本指南参考国外国内的最新研究成果,结合中国的实际情况和专家经验制定,旨在规范中国MF的诊断、治疗与管理流程。

     

    Abstract: Mycosis fungoides (MF) is a cutaneous lymphoma originating from memory helper T cells. The lesion caused by classical type of MF is characterized by the progression from patches at early stages, advancing to more infiltrated plaques and eventually to tumors or erythroderma. Lymph nodes and visceral organs may be involved. The clinical course can last for decades. Early diagnosis of MF is difficult, usually requiring regular follow-up, repeated skin biopsy, and comprehensive analysis of the clinical manifestations, and involving histopathology, immunophenotype, and molecular biology. The treatment of MF should be determined on the stage of the disease. Patients with early-stage MF should be treated with skin-directed therapy, such as topical drugs, phototherapy, and radiotherapy. Advanced-stage MF or recurrent and refractory early-stage MF needs systemic treatments which can be combined with skin-directed treatment to alleviate symptoms. Multidisciplinary treatment (MDT) model is important for the management of patients with MF. The MDT team should conduct an overall evaluation of the patients when formulating the treatment plan, fully weighing the possible benefits, patient tolerance and side effects of treatment, so as to delay the progress of the disease and improve the quality of life of patients. With reference to the latest international and national research data, combined with the true state of China and expert experience, we developed the guidelines to standardize the process of diagnosis, treatment, and management of MF in China.

     

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