Topical steroid monotherapy confers benefits in mycosis fungoides

Treatment with topical corticosteroid monotherapy in early-stage mycosis fungoides (MF) can lead to measurable improvements in body surface area (BSA) and modified Severity-Weighted Assessment Tool (mSWAT) scores and even achievement of complete remission in some patients, a study has found.

“Topical corticosteroids alone or in combination with other therapies are widely used to treat MF, but data on response rates to their use as monotherapy in MF are limited,” the authors said.

To assess the efficacy of topical corticosteroid monotherapy in MF, as well as compare sex, age, stage distributions, and histopathologic features between responders and nonresponders, a retrospective cross-sectional review was carried out on patients with MF from 2013 to 2019 treated at Thomas Jefferson University.

Those with biopsy-proven MF, all stages, who received topical corticosteroid monotherapy were eligible for the study. The authors then determined the response rates by percent chance in BSA involvement and mSWAT.

One hundred sixty-three patients with MF were included, of whom 37 (23 percent) initially received topical steroid monotherapy. Of the treated patients, 27 (73 percent) improved (average decrease in BSA, 65 percent; in mSWAT, 67 percent), 10 (27 percent) did not respond or progress (average increase in BSA, 51.6 percent; in mSWAT, 57 percent), and 12 (33 percent) had a complete response (BSA, 0 percent) with prolonged use of topical steroid.

Of note, early-stage MF and female sex were more represented in responders, according to the authors.

The study was limited by its single-centre retrospective design.