a) Patch or Plaque stage disease limited to geographical region that can be reasonably encompassed by limited radiation field(s)
b) Diffuse patch or plaque stage disease: Patients with diffuse involvement of the skin are treated with topical therapy. There is no evidence that one topical therapy is superior in terms of efficacy or side effects. Treatment is continued in an adjuvant fashion until 1 year AFTER clearance of clinical disease
Skin Directed therapies include:
- Topical Chemotherapy : daily use Nitrogen Mustard or CCNU
- Light therapy: 2-3 weekly PUVA or Narrow Band UVB
- Total Skin Electron Beam Radiation Therapy: duration 1 month but not currently available in BC