Role of bath psoralen plus ultraviolet A in early-stage mycosis fungoides

J Am Acad Dermatol. 2014 Sep;71(3):536-41. doi: 10.1016/j.jaad.2014.04.011. Epub 2014 May 15.

Abstract

Background: Psoralen plus ultraviolet (UV) A (PUVA) radiation is the preferred treatment for folliculotropic mycosis fungoides (MF) and MF refractory to narrowband (NB) UVB radiation. However, systemic PUVA has many unfavorable side effects and contraindications. Bath PUVA has been found to be a suitable alternative in patients with psoriasis, but data on MF are sparse.

Objective: The purpose of the study was to evaluate the effectiveness of bath PUVA in the treatment of folliculotropic MF and NB-UVB-refractory early-stage MF.

Methods: The study group included 26 patients of average age 44 years attending a tertiary medical center in 2004 through 2012, 14 with folliculotropic type and 12 with NB-UVB-refractory early-stage MF who were not amenable for oral PUVA. Treatment consisted of 0.2 mg/L 8-methoxypsoralen bath 3 times weekly followed by UVA irradiation at 0.3 J/cm(2) with fixed increments every second session.

Results: A complete clinical response was achieved in 62% of patients after an average of 33 weeks and a cumulative radiation dose of 158 J/cm(2).

Limitations: This was a relatively small series.

Conclusion: Bath PUVA is a good treatment option for superficial folliculotropic MF and NB-UVB-refractory early-stage MF.

Keywords: bath psoralen plus ultraviolet A; cutaneous T- cell lymphoma; folliculotropic mycosis fungoides; mycosis fungoides; narrowband ultraviolet B.

MeSH terms

  • Abnormalities, Multiple / pathology
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Baths*
  • Child
  • Darier Disease / pathology
  • Eyebrows / abnormalities
  • Eyebrows / pathology
  • Female
  • Ficusin / administration & dosage
  • Humans
  • Male
  • Middle Aged
  • Mycosis Fungoides / drug therapy*
  • Narrow Band Imaging
  • PUVA Therapy / methods*
  • Photosensitizing Agents / administration & dosage
  • Treatment Outcome
  • Young Adult

Substances

  • Photosensitizing Agents
  • Ficusin

Supplementary concepts

  • Burnett Schwartz Berberian syndrome