Whether parapsoriasis represents an early stage of T-cell cutaneous lymphoma is still the subject of controversy. We evaluated the efficacy of phototherapy in the treatment of parapsoriasis and its relation with TCCL. Patients diagnosed with parapsoriasis and treated with phototherapy PUVA or UVB-NB were selected. Between 1 to 8 years following treatment the evolution of their disease was evaluated. In 62 patients the cure rate was 79.3% and 17.2% showed improvement of the lesions. Only two patients developed full blown T-cell cutaneous lymphoma. Phototherapy is an excellent treatment for parapsoriasis, with high cure rates, regardless of the type of phototherapy employed. Of the 62 patients under study, parapsoriasis showed no general tendency to progress to T-cell cutaneous lymphoma.
flared was 211.7 days (range: 7-733 days). Pus cultures for the lesion sites were all positive for Staphylococcus aureus infection, and three were infected with methicillin-resistant Staphylococcus aureus (MRSA), which was defined as Staphylococcus aureus genetically having mecA or mecC genes or phenotypically showing a minimum inhibitory concentration (MIC) of oxacillin that is higher than 2 mg/l. 1 However, all of the patients had clinical improvement within 2 weeks of starting the dicloxacillin solution treatment (Fig. 1), and none had to reduce or discontinue their EGFRI therapy or encountered any adverse events caused by the dicloxacillin solution.EGFRI-induced adverse effects such as PPE and PDE might markedly decrease patient quality of life and cause interruptions of the anticancer therapy. 2 Although previous publications have mentioned possible mechanisms for these effects, they have typically viewed them as resulting from an inflammatory process rather than an infection. [3][4][5] Using topical steroids or antibiotics for these lesions will not achieve good responses in some patients. Prophylactic oral minocycline or doxycycline for such patients seems to reduce the prevalence of facial PPE in the first few weeks. 6 However, after a period of oral antibiotics prophylaxis, facial PPEs still frequently recur with or without super infection. Meanwhile, frequent oral antibiotics prophylaxis or treatment for PPE not only causes gastrointestinal discomfort but also significantly increases systemic antibiotic consumption by patients, contributing to the emergence of multi-resistant strains of bacteria like MRSA.Topical dicloxacillin solution wash could thus not only be a promising treatment for PPE and PDE but could also reduce the total amount of antibiotics used by patients receiving EGFRI treatment. One potential explanation is that the locally high concentration of dicloxacillin (1,000 mg/l) could overcome drug resistance. Relatedly, we hope this study can serve as a reference for managing EGFRI-induced adverse events.
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