The diagnosis of early-stage mycosis fungoides: Views held by experts and non-experts in cutaneous lymphoma

BACKGROUND AND OBJECTIVES: Mycosis fungoides (MF) accounts for the majority of cutaneous lymphomas (CL). There is a documented delay in the diagnosis of early-stage MF. However, its timely diagnosis is paramount to avoid potentially harmful therapies and undue patient distress. The aim of this study was to examine and compare the views held by both specialists and non-specialists in CL regarding the diagnosis of early-stage MF, to identify clinical needs.

METHODS: Two distinct questionnaires were distributed to physicians, who either have a potential or no special interest in CL (non-specialists), or who have a special interest in CL (specialists) and who were identified by participation in the PROCLIPI (PROspective Cutaneous Lymphoma International Prognostic Index) study.

RESULTS: Survey results were received from 382 participants, 86 specialists, and 296 non-specialists. In total, 82% of respondents held the view that the diagnosis of early-stage MF is delayed. The frequent misclassification of MF as a benign inflammatory dermatosis was identified as the most important contributing factor.

CONCLUSIONS: Non-specialists assume that a delayed diagnosis impairs therapeutic efficacy and prognosis in MF, while specialists primarily suspect negative effects on patients' health-related quality of life. Our study reveals an unmet need to promote education and increase awareness among dermatologists regarding the impact of early-stage MF on patient management.