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Old 09-26-2012
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Default A 45-yr old man with patchy dry areas on his skin.

A 45-year-old man presents to his primary care
physician with a complaint of patchy dry areas
on his skin. After several trials of skin emollients
and corticosteroid therapies without improvement,
the lesions are biopsied by a dermatologist.
Pathologic examination reveals a
population of atypical mononuclear cells infi ltrating
the dermis and epidermis. A complete
blood cell count is normal, and no atypical
cells are observed on peripheral blood smear.
The patient states that he feels quite well.
Which of the following is most appropriate as
recommended by the patient’s dermatologist?

(A) Anticipation of bone marrow transplant
(B) Observation alone
(C) Systemic chemotherapy
(D) Systemic corticosteroids
(E) Treatment of the affected areas of skin with
topical nitrogen mustard
(F) Treatment of the entire skin surface via total
skin electron beam therapy
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  #2  
Old 09-26-2012
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(E) Treatment of the affected areas of skin with topical nitrogen mustard

Quote:
Topical mycosis fungoides treatments, such as topical steroids, topical retinoids, topical chemotherapy, and light treatment that may be enhanced by the ingestion of psoralen, are used to induce remissions, which may be lengthy in patients whose disease is largely confined to the skin.
Generally, in the patch or plaque phase of the disease, use topical steroids, topical retinoids, topical chemotherapy (eg, nitrogen mustard or bischloroethylnitrosourea [BCNU]), ultraviolet B (UV-B) light or UV-A light treatment enhanced with psoralen (PUVA), or total body electron beam radiation These modalities are also used in the tumor phase combined with systemic modalities (eg, PUVA plus interferon).
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