Quality of life in CTCL
3rd Nov 2021
Interview and article by Christine Clark, PhD, FRPharmS.
The impact of mycosis fungoides (MF) and Sézary syndrome (SS), and other cutaneous lymphomas in general, on the quality of life (QoL) is profound, according to Professor Margarida Lima (Haematology Department, University of Porto Hospital Centre). This is related to several factors, namely the cutaneous lesions themselves, the associated pruritus, secondary or opportunistic infections and constitutional symptoms.
Cutaneous lesions
In general, skin lesions, especially if on exposed areas of the skin, can create family and social problems, related to feelings of repulsion and disgust, and to the fear, albeit unfounded, of contagion. They cause great emotional suffering and problems with self-image. Lesions located on the face or genital areas and disfiguring, large, ulcerated or infected skin lesions can be especially problematic. The same applies to the generalised, exfoliative erythroderma observed in patients with SS which causes extreme discomfort to the patient.
Pruritus
Pruritus in patients with CTCL, especially those with SS, is often very difficult to control, interfering with sleep and functioning, and having a major negative impact on the QoL.
Secondary / opportunistic infections
Damage to the skin barrier combined with immunosuppression associated with CTCL and multiple therapies, can predispose patients to secondary infections, often with opportunistic organisms. Such infections frequently require hospitalisation, are difficult to treat and are a major cause of morbidity and mortality.
Constitutional symptoms
For patients with advanced CTCL, constitutional symptoms may also have a profound impact on the QoL.