{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T01:58:06Z","timestamp":1777514286677,"version":"3.51.4"},"reference-count":67,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Med Surg"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>Mycosis fungoides (MF) and S\u00e9zary syndrome (SS) are subtypes of cutaneous T-cell lymphoma with numerous topical and systemic therapies. Early-stage MF can be managed with topical corticosteroids, mechlorethamine, and phototherapy. However, patients are often non-responsive to topical therapies, thus requiring systemic therapies. There are few studies summarizing oral (PO) therapies for MF and SS. We aim to discuss the efficacy and safety of FDA-approved, off-label, and investigational oral therapies for MF and SS. FDA-approved oral therapies include bexarotene and vorinostat, both of which are effective in patients who are recalcitrant to prior topical therapies. Off-label oral therapies include methotrexate, acitretin, and chlorambucil. Methotrexate improves MF lesions in both early-stage and late-stage MF and is effective in erythrodermic MF. A combination of acitretin with phototherapy may lead to better response rates compared to acitretin monotherapy. Chlorambucil is mainly used to treat erythrodermic MF. Investigational oral therapies for MF include tenalisib, duvelisib, cerdulatinib, lenalidomide, bortezomib, and azacytidine, and direct comparison studies between these investigational agents and FDA-approved therapies should be undertaken to better understand their role in the management of MF and SS.<\/jats:p>","DOI":"10.1177\/12034754251322881","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T11:47:22Z","timestamp":1741780042000},"page":"497-506","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of Mycosis Fungoides and S\u00e9zary Syndrome With Oral Systemic Therapies"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7056-3708","authenticated-orcid":false,"given":"Jonathan D.","family":"Greenzaid","sequence":"first","affiliation":[{"name":"Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8637-8458","authenticated-orcid":false,"given":"Sach","family":"Thakker","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ainsley J.","family":"Ruley","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin M.","family":"Eichinger","sequence":"additional","affiliation":[{"name":"University of Louisville School of Medicine, Louisville, KY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay C.","family":"Strowd","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"issue":"10","key":"e_1_3_2_2_2","first-page":"978","article-title":"Immunohistochemical analysis of mycosis fungoides on paraffin-embedded tissue sections","volume":"11","author":"Izban KF","year":"1998","unstructured":"Izban KF, Hsi ED, Alkan S. Immunohistochemical analysis of mycosis fungoides on paraffin-embedded tissue sections. Mod Pathol. 1998;11(10):978-982.","journal-title":"Mod Pathol"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.1999.tb01824.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-09-3502"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2023.2634"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1159\/000018423"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2019.00116"},{"key":"e_1_3_2_8_2","volume-title":"Primary Cutaneous Lymphomas","author":"National Comprehensive Cancer Network","unstructured":"National Comprehensive Cancer Network. Primary Cutaneous Lymphomas. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines)."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V88.7.2385.bloodjournal8872385"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2017.02.027"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-07-588236"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.138.3.325"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20952"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2019.00907"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2020.0022"},{"issue":"5","key":"e_1_3_2_16_2","first-page":"581","article-title":"Phase 2 and 3 clinical trial of oral bexarotene (targretin capsules) for the treatment of refractory or persistent early-stage cutaneous T-cell lymphoma","volume":"137","author":"Duvic M","year":"2001","unstructured":"Duvic M, Martin AG, Kim Y, et al. Phase 2 and 3 clinical trial of oral bexarotene (targretin capsules) for the treatment of refractory or persistent early-stage cutaneous T-cell lymphoma. Arch Dermatol. 2001;137(5):581-593.","journal-title":"Arch Dermatol"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.9.2456"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2012.11156.x"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0781.2007.00315.x"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.3109\/09546630903103980"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-11-4570"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2003.11.058"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2002.124607"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12042"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1517\/13543784.14.12.1497"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-06-025999"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2006.24.18_suppl.7500"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.10.2434"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.26355\/eurrev_201806_15185"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0190-9622(96)80062-4"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0190-9622(96)80062-4"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1089\/cbr.2007.0402"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1080\/09546630802562427"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.2340\/00015555595963"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1995.01690150071014"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.21037\/cco.2019.01.02"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10227-001-0040-y"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.02.044"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8019.2006.00083.x"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1080\/09546634.2018.1487525"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.07.013"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16567"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26374"},{"key":"e_1_3_2_44_2","unstructured":"Zito PM Patel P Mazzoni T. Acitretin. In: StatPearls. [Internet]. Treasure Island (FL): StatPearls Publishing 2025. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK519571\/"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.3109\/10428199609054821"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2000.03601.x"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx352"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.884091"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2011.02.006"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12082293"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.819128"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2022.281875"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1080\/13543784.2017.1312338"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-08-802470"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1093\/oncolo\/oyad345"},{"key":"e_1_3_2_56_2","first-page":"725","volume-title":"Drug-Induced Liver Disease","author":"Hoofnagle JH","unstructured":"Hoofnagle JH. LiverTox: a website on drug-induced liver injury. In: Drug-Induced Liver Disease. Elsevier; 2013:725-732."},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2008.77"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-immunol-110416-120628"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2019-123986"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1186\/1756-8722-2-36"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-09-525915"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.02.050"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.03.108"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.01.133"},{"key":"e_1_3_2_65_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.11.4207"},{"key":"e_1_3_2_66_2","doi-asserted-by":"publisher","DOI":"10.1177\/2040620712464882"},{"key":"e_1_3_2_67_2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-15-1435"},{"key":"e_1_3_2_68_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2022009445"}],"container-title":["Journal of Cutaneous Medicine and Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/12034754251322881","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/12034754251322881","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/12034754251322881","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:51:41Z","timestamp":1777391501000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/12034754251322881"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,12]]},"references-count":67,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1177\/12034754251322881"],"URL":"https:\/\/doi.org\/10.1177\/12034754251322881","relation":{},"ISSN":["1203-4754","1615-7109"],"issn-type":[{"value":"1203-4754","type":"print"},{"value":"1615-7109","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,12]]}}}