Psychosocial burden of patients with mycosis fungoides and Sézary syndrome compared to other dermatological patients. Pilot study

Introduction:
Cutaneous T-cell lymphoma (CTCL), including mycosis fungoides (MF) and Sézary syndrome (SS), significantly affects patients’ quality of life (QoL) due to its chronic and progressive nature. Both conditions often lead to diagnostic delays and have a profound impact on daily activities and emotional well-being.

Aim:
This study aimed to evaluate the QoL impairment in patients with MF and SS compared to individuals with psoriasis vulgaris and other dermatological diseases. Additionally, the study explored the potential role of high-frequency ultrasound (HFUS) in monitoring CTCL.

Material and methods:
A total of 104 patients, including 16 with MF, 1 with SS, 34 with psoriasis, and 53 with other dermatological diseases, were recruited from the University Centre of General Dermatology and Oncodermatology of the Wroclaw Medical University. QoL was assessed using the Polish version of the Dermatology Life Quality Index (DLQI) questionnaire. Statistical analyses included descriptive statistics, the Shapiro-Wilk test, and the Kruskal-Wallis H test.

Results:
Patients with CTCL had reduced QoL, with DLQI scores ranging from 2 to 22 (median: 10). However, intergroup comparisons showed no statistically significant differences between CTCL, psoriasis, and other dermatological disorders. HFUS emerged as a promising tool for assessing disease progression by measuring epidermal thickness, subepidermal low-echogenic band (SLEB) changes.

Conclusions:
CTCL significantly impairs QoL, necessitating individualized management strategies. While treatments like low-dose total skin electron beam therapy (TSEBT) and extracorporeal photopheresis (ECP) offer QoL improvements, disease progression remains a concern. HFUS shows potential as a non-invasive diagnostic and monitoring tool, but further research is needed to validate its routine clinical application.