CTCL evaluation documentation prompts
Reviewed 23 September 2026

App-authored prompts, not findings. Complete only what was assessed. Leave unavailable information as not recorded. Do not paste this document as a completed examination.

History and reason for consultation: [record]
Symptoms and their course: [record]
Prior biopsies and the actual reported results: [record; multiple biopsies do not imply nondiagnostic results]
Prior and current therapies and responses: [record]
Examination scope and findings: [record what was examined]
Skin distribution, morphology and clinician-assessed extent: [record]
Lymph node examination: [not assessed / recorded findings]
Pathology, blood and imaging results: [record; do not infer negatives from missing tests]
Assessment and diagnostic uncertainty: [record]
Clinician-assigned subtype and stage, if established: [record]
Actions: [specify considered / planned / ordered / completed separately]
Follow-up date and action: [record]

MF/SS staging requires TNMB assessment and does not apply to every CTCL subtype.
ISCL/USCLC/EORTC staging update: https://pmc.ncbi.nlm.nih.gov/articles/PMC9353153/

For regional mSWAT entries, record non-overlapping areas, convert regional percentages to whole-body BSA, then weight patches x1, plaques x2 and tumors x4. Missing assessment is not zero involvement.
ISCL/USCLC/EORTC consensus: https://doi.org/10.1200/JCO.2010.32.0630

No prognostic group is assigned by this template. The original 2013 CLIPi and newer advanced-disease CLIPI are different models. Specialist review is needed before applying either.
Original study: https://pubmed.ncbi.nlm.nih.gov/23735705/
Newer advanced-disease study: https://pubmed.ncbi.nlm.nih.gov/40663780/