How do you approach balancing the potential risk of worsening actinic damage and maintaining CTCL clearance in patients treated with nb-UVB?  

NB-UVB continues to be the most effective skin directed therapy for patch MF. I try to use it as much as possible as monotherapy, or commonly in combination with retinoids for treatment and maintenance of early-stage disease. In patients with severe solar damage, I may continue phototherapy adding l...

The management of CTCL almost always has taken priority over managing chronic dermatoheliosis, actinic keratoses or other UV induced changes in my patients.  There is surely a very small subset of patients that have reached their lifetime limit of sun exposure in MF affected areas, but those MF...