Pilot study of a novel therapeutic approach for refractory advanced stage folliculotropic mycosis fungoides

Folliculotropic mycosis fungoides is a variant of cutaneous T-cell lymphoma characterized as having a fol-liculocentric infiltrate of malignant T cells along with a worse prognosis in comparison to the epidermotropic variants. Patients with advanced forms of folliculotro-pic mycosis fungoides are often poorly responsive to both skin-directed as well as to systemic therapies. We report here a high response rate using a novel therapeutic regimen combining interferon gamma, isotreti-noin in low dose and topical carmustine, and in some cases concomitant skin-directed therapies, among 6 consecutive patients with refractory folliculotropic mycosis fungoides with stages IB through IIIB who had previously failed both topical and systemic thera-pies. The potential mechanisms of this multimodality approach are discussed.