Bath‐water PUVA Therapy with 8‐Methoxypsoralen in Mycosis Fungoides

Weber, Florian; Schmuth, Matthias; Sepp, Norbert; Fritsch, Peter

doi:10.1080/00015550510032814

Cited by 27 publications

(14 citation statements)

References 32 publications

(31 reference statements)

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“…Technically, PUVA in MF is generally performed according to the guidelines established for the treatment of psoriasis (38,39). Although bath PUVA with 8-methoxypsoralen has been shown in a retrospective analysis to be effective, its use in MF is not generally accepted because the head is usually not exposed to the photosensitizer and relapses might preferentially occur in nontreated areas (40). Treatment is usually applied until complete clinical clearing is achieved.…”

Section: Puvamentioning

confidence: 99%

Phototherapy of mycosis fungoides

Trautinger

2011

Photoderm Photoimm Photomed

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SummaryBackground/purpose: Among the primary cutaneous T-cell lymphomas, mycosis fungoides (MF) is the most common disease entity. Recently, an improved understanding of the pathology, clinical presentation, and prognosis of MF has lead to the development of new and practically useful classification and staging systems. In most patients, MF presents with patches and plaques and remains confined to the skin for years and decades, making it an ideal target for phototherapy. However, treatment schedules vary widely and this review describes the current knowledge about phototherapy of MF focusing mainly on narrow-and broadband UVB and 8-methoxypsoralen plus UVA, its indications, practical aspects, and clinical outcome. Methods: Review and summary of the pertinent literature. Results and conclusions: Since 1976, when the first report on phototherapy for MF was published, sufficient evidence has accumulated to make narrowband UVB and PUVA safe and effective treatment options for early stages of the disease. In refractory cases or more advanced stages, combination of phototherapy with systemic treatments including mainly interferons and retinoids might be valuable. Additional research is required to further define the optimal treatment schedules and the role of maintenance.

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Section: Puvamentioning

confidence: 99%

Phototherapy of mycosis fungoides

Trautinger

2011

Photoderm Photoimm Photomed

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“…The results were comparable to oral PUVA. [18] Bath PUVA has also been tried in childhood mycosis fungoides. In a retrospective review of 28 children, 79% of whom had hypopigmented mycosis fungoides, use of NB-UVB phototherapy and bath PUVA led to complete or partial remission in 19 out of 22 patients after a median of 4 months.…”

Section: Puva Initial Clearing Regimenmentioning

confidence: 99%

Phototherapy for mycosis fungoides

Dogra

Mahajan

2015

Indian J Dermatol Venereol Leprol

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Photochemotherapy in the form of psoralens with ultraviolet A (PUVA) is a safe, effective, and well tolerated first line therapy for the management of early stage mycosis fungoides (MF), that is, stage IA, IB, and IIA (Level of evidence 1+, Grade of recommendation B). The evidence for phototherapy in the form of narrow-band UVB (NB-UVB) is less robust (Level of evidence 2++, Grade of recommendation B) but may be considered at least as effective as PUVA in the treatment of early-stage MF as an initial therapy. In patients with patches and thin plaques, NB-UVB should be preferentially used. PUVA may be reserved for patients with thick plaques and those who relapse after initial NB-UVB therapy. For inducing remission, three treatment sessions per week of PUVA phototherapy or three sessions per week of NB-UVB phototherapy may be advised till the patient achieves complete remission. In cases of relapse, patients may be started again on PUVA monotherapy or PUVA may be combined with adjuvants like methotrexate and interferon (Level of evidence 2+, Grade of recommendation B). Patients with early-stage MF show good response to combination treatments like PUVA with methotrexate, bexarotene or interferon-α-2b. However, whether these combinations hold a significant advantage over monotherapy is inconclusive. For late stage MF, the above-mentioned combination therapy may be used as first-line treatment (Level of evidence 3, Grade of recommendation C). Currently, there is no consensus regarding maintenance therapy with phototherapy once remission is achieved. Maintenance therapy should not be employed for PUVA routinely and may be reserved for patients who experience an early relapse after an initial course of phototherapy (Level of evidence 2+, Grade of recommendation B). Bath-water PUVA may be tried as an alternative to oral PUVA in case the latter cannot be administered as the former may show similar efficacy (Level of evidence 2-, Grade of recommendation C). In pediatric MF and in hypopigmented MF, both NB-UVB and PUVA may be tried (Level of evidence 3, Grade of recommendation D).

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“…Un estudio en 16 pacientes con estadios tempranos muestra una respuesta completa en todos los pacientes después de 63 días de tratamiento con una dosis acumulada de 33 J/cm 2 y el tiempo de recaída fue de 45,6 ± 9,2 semanas, mostrando buenos resultados, pero se requieren estudios con un mayor número de pacientes (21).…”

Section: Baños De Puvaunclassified

Cuándo emplear PUVA o NB-UVB en micosis fungoide

Roldán

Jiménez²

2016

CES Med

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ResumenLa micosis fungoide es un linfoma cutáneo de células T de etiología desconocida que afecta principalmente a la población adulta. En sus fases iniciales la fototerapia sigue siendo una de las principales opciones terapéuticas. La terapia con NB-UVB en estadios tempranos IA-IB en parches y placas delgadas ofrece ventajas sobre el PUVA, debido a su mejor tolerancia y menores efectos secundarios; la terapia PUVA sigue siendo la elección en micosis fungoide en placas de mayor grosor. En cuanto a la terapia de mantenimiento se plantea que podría estar asociada a mayor radiación acumulada, sin lograr prevenir futuras lesiones, siendo el antecedente de recaída el principal factor predisponente para presentar nuevas lesiones en el futuro.Palabras clave: Micosis fungoide, Fototerapia, PUVA, UVB, Tratamiento de la micosis fungoide. AbstractMycosis fungoides (MF) is a cutaneous T-cell lymphoma of unknown etiology that primarily affects the adult population. In early stages of the disease phototherapy is a major therapeutic option. At the time NB-UVB therapy in early stages IA-IB patchy and thin plaques offers advantages over PUVA, due to its better tolerance and fewer side effects, the PUVA therapy remains the choice to MF in thinner plaques. The maintenance therapy is posed that could be associated with higher accumulation of radiation without achieving prevents future lesions, being the history of relapse the main predisposing factor to present new lesions in the future.

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Bath‐water PUVA Therapy with 8‐Methoxypsoralen in Mycosis Fungoides

Cited by 27 publications

References 32 publications

Phototherapy of mycosis fungoides

Phototherapy of mycosis fungoides

Phototherapy for mycosis fungoides

Cuándo emplear PUVA o NB-UVB en micosis fungoide

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