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Mycosis fungoides (MF) and S é zary syndrome (SS) are the most common forms of cutaneous T cell lymphoma (CTCL), and most frequently manifest as CD4 CD45RO malignant T cells with T cell receptor clonality [1]. MF and SS are often refractory to standard chemotherapeutic treatments, which expose patients to toxicity often without substantial benefit. Because of the limited efficacy of existing treatments, several novel immune-modulating therapies for MF and SS are under investigation, including imiquimod and oligodeoxynucleotides (ODNs), ligands for Toll-like receptor 7 (TLR7) and TLR9, respectively. Imiquimod is already Food and Drug Administration (FDA) approved for the treatment of basal cell carcinoma, actinic keratoses and condyloma. In a published case report, administration of the synthetic TLR7 ligand imiquimod successfully treated a cancerous skin plaque that was resistant to standard therapy …