Mycosis Fungoides and Melanoma: Insights for Derm

Amrita Goyal-O’Leary, MD, is a board-certified dermatologist and recent graduate of the dermatopathology fellowship at Massachusetts General Hospital. She is also board-eligible in Internal Medicine. Her expertise involves the intersection between dermatology and hematology/oncology, particularly cutaneous lymphoma and dermato-oncology. Her primary research interests include the clinical management and dermatopathic diagnosis of rare cutaneous T-cell lymphomas and the varied cutaneous manifestations of systemic cancers. She is the lead author of a series of research papers published in the prestigious Journal of the American Academy of Dermatology and the European Journal of Dermatology and Venereology documenting that patients with mycosis fungoides (MF), a rare T-cell lymphoma of the skin, have an increased risk of developing second cancers. MF patients have a significantly increased risk of  non-Hodgkin lymphoma, Hodgkin lymphoma,  lung cancer, bladder cancer, and melanoma. In conjunction with a group of dermatologists and oncologists from across the country, she is in the process of creating cancer screening guidelines for MF patients.

In this video Dr Goyal shares her unique tips and insights for fellow dermatologists regarding mycosis fungoides and melanoma.

You can also watch her discuss her latest research focusing on second malignancies in mycosis fungoides here.

Transcript:
Dr Goyle: Right now, it's recommended that every patient we see for mycosis fungoides receive a full‑body skin exam and lymph node exam at least every year. By and large, we are really nailing that.

What I really want clinicians to take away from this is that they need to be doing a pigmented lesion‑focused exam, and not just assessing body surface area, the presence of patches, plaques, and tumors.

They really need to be paying specific attention to pigmented lesions, which can be very challenging in the setting of extensive MF, where patients have large patches and plaques that may obscure underlying pigmented lesions, and I think in those cases, serial photography asking the patients to really follow the A, B, C, D, Es, and working on patient education will be the real keys.

I just wanted to share that, by and large, people are doing an excellent job taking care of these patients, and there has been a dramatic improvement in survival over the last 40 years.

I think that, if we work together with each other and with primary care providers, I think that we can continue to make a big difference in the quality of life and the quantity of life that these patients experience.