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Q1: Definition and clinical presentation (2 min)
What is cutaneous T-cell lymphoma? How does mycosis fungoides (MF) typically present, and what is the typical diagnostic delay? Define Sezary syndrome (SS) and the diagnostic triad.
Q2: Differential diagnosis (3 min)
A 58-year-old man has a 3-year history of an eczematous rash on the buttocks that has failed multiple topical corticosteroids. What conditions would you consider in the differential diagnosis, and what features would make you suspect MF?
Q3: Investigations (2 min)
What investigations would you arrange to confirm the diagnosis? Describe the ISCL/EORTC TNMB staging system and the prognostic implications of each T, N, M and B category.
Q4: Management (3 min)
Outline your stepwise approach to management. What are the first-line, second-line, and refractory treatments for early MF, tumour-stage MF, erythrodermic MF, and Sezary syndrome? Discuss the role of ECP, bexarotene, mogamulizumab and brentuximab vedotin.
Q5: Complications and prognosis (2 min)
What are the main complications of CTCL? What prognostic factors influence survival, and what is the typical prognosis by stage? Discuss large cell transformation and the role of allogeneic stem cell transplantation.