Narrowband (311-nm) UV-B Therapy for Small Plaque Parapsoriasis and Early-Stage Mycosis Fungoides

Hofer, Angelika; Cerroni, Lorenzo; Kerl, Helmut; Wolf, Peter

doi:10.1001/archderm.135.11.1377

Cited by 131 publications

(95 citation statements)

References 13 publications

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“…Psoralen, which forms DNA adducts upon photoactivation, combined with ultraviolet A (PUVA) causes tumor cell apoptosis and is associated with a complete response rate exceeding 90%, and a prolonged disease-free interval, in patients with stage IA/IB disease [212,213]. In contrast to PUVA, use of either broadband or narrowband ultraviolet B (UVB) does not require psoralen and is associated with a high clinical and pathologic complete response rate, particularly for patients with patch-stage disease [214][215][216][217][218]. Malignant T cells are radiosensitive.…”

Section: Treatment Of Limited-stage Mfmentioning

confidence: 99%

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

Wilcox

2011

American J Hematol

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Disease overview: Cutaneous T‐cell lymphomas are a heterogenous group of T‐cell lymphoproliferative disorders involving the skin, the majority of which may be classified as Mycosis fungoides (MF) or Sézary syndrome (SS).Diagnosis: The diagnosis of MF or SS requires the integration of clinical and histopathologic data.Risk‐adapted therapy: Tumor, node, metastasis, and blood (TNMB) staging remains the most important prognostic factor in MF/SS and forms the basis for a “risk‐adapted,” multidisciplinary approach to treatment. For patients with disease limited to the skin, expectant management or skin‐directed therapies is preferred, as both disease‐specific and overall survival for these patients is favorable. In contrast, patients with advanced‐stage disease with significant nodal, visceral, or blood involvement are generally approached with biologic‐response modifiers, denileukin diftitox, and histone deacetylase inhibitors before escalating therapy to include systemic, single‐agent chemotherapy. Multiagent chemotherapy may be used for those patients with extensive visceral involvement requiring rapid disease control. In highly‐selected patients with disease refractory to standard treatments, allogeneic stem‐cell transplantation may be considered. Am. J. Hematol., 2011. © 2011 Wiley‐Liss, Inc.

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Section: Treatment Of Limited-stage Mfmentioning

confidence: 99%

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

Wilcox

2011

American J Hematol

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“…The disadvantage of UVB is its somewhat lower response rate and duration of remission and less effective than PUVA with thicker lesions. 28,29 PUVA has been reported to achieve improved response rates when combined with interferon-␣-2b (IFN-␣) 30,31 or retinoids such as acitretin. 32 PUVA therapy has also been used as a salvage or maintenance therapy after total skin electron beam (TSEB) therapy.…”

Section: Overviewmentioning

confidence: 99%

How I treat mycosis fungoides and Sézary syndrome

Prince

Whittaker

Hoppe

2009

Blood

136

109

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The most common subtypes of primary cutaneous T-cell lymphomas are mycosis fungoides (MF) and Sézary syndrome (SS). The majority of patients have indolent disease; and given the incurable nature of MF/SS, management should focus on improving symptoms and cosmesis while limiting toxicity. Management of MF/SS should use a “stage-based” approach; treatment of early-stage disease (IA-IIA) typically involves skin directed therapies that include topical corticosteroids, phototherapy (psoralen plus ultraviolet A radiation or ultraviolet B radiation), topical chemotherapy, topical or systemic bexarotene, and radiotherapy. Systemic approaches are used for recalcitrant early-stage disease, advanced-stage disease (IIB-IV), and transformed disease and include retinoids, such as bexarotene, interferon-α, histone deacetylase inhibitors, the fusion toxin denileukin diftitox, systemic chemotherapy including transplantation, and extracorporeal photopheresis. Examples of drugs under active investigation include new histone deacetylase inhibitors, forodesine, monoclonal antibodies, proteasome inhibitors, and immunomodulatory agents, such as lenalidomide. It is appropriate to consider patients for novel agents within clinical trials if they have failed front-line therapy and before chemotherapy is used.

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“…9 Unlike PUVA, with which maintainance is effective, once-weekly treatment with TL-01, attempted for 1 patient (case 3), proved difficult because painful posttreatment erythema developed despite UV-B dose reduction.…”

Section: Commentmentioning

confidence: 99%

“…4 Although several studies have suggested that narrowband TL-01 is more effective than broadband UV-B in the treatment of psoriasis, [5][6][7][8] there is only 1 report of its use in MF. 9 …”

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confidence: 99%