Aims: To discuss the role of phototherapy, oral retinoids, radiation, vorinostat and brentuximab for treating refractory mycosis fungoides (MF). MF is the commonest type of cutaneous T-cell lymphoma (CTCL). MF is treatable but not curable. Treatment focuses on providing remission, prolonging progression, and improving patients' quality of life. The multidisciplinary team usually consists of a dermatologist, haematologist, radiation oncologist and general practitioner.

Methods: We discuss the case of a man in his 60’s with recurrent CD30+ large cell transformation that had progressed to tumour stage MF.

Results: Our patient is managed with a multidisciplinary team as described above. He is presently on vorinostat, and will be considered for brentuximab in future. Oral retinoids had to be reintroduced to reduce his skin cancer burden.

Conclusions: Vorinostat is a histone deacetylase inhibitor used in the management of cutaneous T cell lymphoma. Brentuximab is an antibody drug conjugate CD30 directed antibody. Both medications are PBS approved for MF patients who have been treated with prior systemic chemotherapy, have relapsed or have chemotherapy-refractory disease, and it must be the sole PBS-subsidised therapy for the condition. Oral retinoids, phototherapy with UVB and UVA1, and radiation are still important additional treatment options.