Recommendations for the treatment (standard therapies) of CD30+ LPD
| PCALCL . | LYP . | |||
|---|---|---|---|---|
| Solitary or grouped lesion(s) . | Multifocal lesions . | Extracutaneous spread . | Localized/regional or few lesions* . | Numerous and/or generalized lesions . |
| SE | Methotrexate | Single or multiagent chemotherapy‡ | Observation | Observation |
| RT | Alternatives: retinoids, interferon† | Phototherapy§ | Phototherapy§ | |
| Topical steroids | Methotrexate | |||
| Topical steroids | ||||
| Alternatives†: retinoids, interferon | ||||
| PCALCL . | LYP . | |||
|---|---|---|---|---|
| Solitary or grouped lesion(s) . | Multifocal lesions . | Extracutaneous spread . | Localized/regional or few lesions* . | Numerous and/or generalized lesions . |
| SE | Methotrexate | Single or multiagent chemotherapy‡ | Observation | Observation |
| RT | Alternatives: retinoids, interferon† | Phototherapy§ | Phototherapy§ | |
| Topical steroids | Methotrexate | |||
| Topical steroids | ||||
| Alternatives†: retinoids, interferon | ||||
For larger (defined as > 2 cm in diameter) and persistent (defined as duration of lesion > 12 weeks) lesions, SE or RT may represent alternatives.
These therapies are of low-level evidence other than expert opinion.
In cases of skin and only local node involvement in PCALCL, one could consider addition of local nodal radiation 4
PUVA is best documented. Alternatively, treatment with other types of phototherapy (eg, UVB-narrow band) can be tried (evidence level 5).