Ultraviolet A1 Phototherapy in the Treatment of Early Mycosis Fungoides

Abstract

Background: Phototherapy has been the mainstay of therapies for early mycosis fungoides (MF). The beneficial role of ultraviolet (UV) light on MF is suggested by the observation that lesions occur on non-sun-exposed areas. Therapeutic light sources that are available today are broadband UVB, psoralen and UVA, narrowband UVB, and long-wave UV (UVA1). Current literature provides increasing evidence on the use of UVA1 to treat MF. Aim: To investigate the treatment responses of early MF patients treated with fixed 30 J/cm² doses of UVA1 phototherapy. Material and Methods: Nineteen patients with early MF, stage IA-IIA of the TNM staging system, received fixed 30 J/cm² doses of UVA1, given 5 times weekly over 5 weeks. Therapeutic effectiveness was assessed by clinical examination and was confirmed by histological evaluation. Results: Of the 19 patients, complete responses were achieved in 12 (63%) and partial responses were achieved in 7 (37%) patients after UVA1 radiation exposures. During the study, UVA1 therapy was well tolerated. During the follow-up, 7 (58%) of the 12 patients with complete response relapsed within 3 months of the UVA1 therapy. Conclusion: The current study provides clinical and histological evidence for the effectiveness of UVA1 (30 J/cm² 5 times a week for 5 weeks) as a skin-directed therapy in the treatment of early MF; however, such a treatment failed to maintain a long and sustained response. Thus, studies to identify the optimal dosing protocol regarding the therapeutic efficacy, the factors affecting relapse time/rate, and the necessity of maintenance treatment are needed.

Maintenance phototherapy for the treatment of early stage mycosis fungoides

“…UVA penetrates the entire dermis and possibly the subcutaneous tissue. Therefore, PUVA represents a good therapeutic option for plaque stage disease (up to 85% of patients with stage IA experienced complete response) (4,11,12). Complete response rates were slightly lower in patients treated with NB-UVB (54% to 90%) (4).…”

A medium dose of UVA1 phototherapy does not diminish vitamin D level in patients with atopic dermatitis

“…Dawki promieniowania UVA1 można podzielić na niskie (20-40 J/cm 2 ), średnie (40-80 J/cm 2 ) i wysokie (80-120 J/cm 2 ) [4]. Fototerapia UVA1 jest stosowana w leczeniu różnych chorób, takich jak twardzina układowa [5,6], postać twardzinowa choroby przeszczep przeciwko gospodarzowi [7,8], liszaj twardzinowy i zanikowy [9], ziarniniak grzybiasty [10,11], lymphomatoid papulosis [12], sarkoidoza skórna [13], AZS, pokrzywka barwnikowa, świerzbiączka guzkowa, ziarniniak obrączkowaty i rogowacenie liszajowate przewlekłe [14].…”

“…The dosage of UVA1 could be classified as low (20-40 J/cm 2 ), medium (40-80 J/ cm 2 ) and high (80-120 J/cm 2 ) [4]. UVA1 phototherapy has been used in various diseases, including scleroderma [5,6], sclerodermic graft-versus-host disease [7,8], lichen sclerosus and atrophicus [9], mycosis fungoides [10,11], lymphomatoid papulosis [12], cutaneous sarcoidosis [13], AD, urticaria pigmentosa, prurigo nodularis, granuloma annulare and keratosis lichenoides chronica [14].…”

Phototherapy of mycosis fungoides

“…Узкополосная средневолновая ультрафиолетовая терапия (УФВ-311 нм) стала применяться позднее, чем ПУВАтерапия, однако успела зарекомендовать себя в качестве эффективного метода в лечении больных грибовидным микозом. В единичных публикациях отражен успешный опыт лечения больных Т-клеточной лимфомой кожи с применением широкополосного ультрафиолетового излучения, УФА-1 и монохромного эксимерного света (308 нм) [3][4][5].…”

“…A. Phototherapy of mycosis fungoides. Onkogematologiya = Oncohematology 2019;14 (4): [18][19][20][21][22][23][24][25][26].…”