Efficacy of Low-Dose Ultraviolet A-1 Phototherapy for Parapsoriasis/Early-Stage Mycosis Fungoides

• Published in: Photochemistry and photobiology Vol. 90; no. 4; pp. 873 - 877
• Main Authors: Aydogan, Kenan, Yazici, Serkan, Balaban Adim, Saduman, Tilki Gunay, Isil, Budak, Ferah, Saricaoglu, Hayriye, Tunali, Sukran, Bulbul Baskan, Emel
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.07.2014
• Subjects: Adult; Aged; Disease management; Female; Humans; Light therapy; Lymphoma; Male; Middle Aged; Mycosis Fungoides - radiotherapy; Parapsoriasis - radiotherapy; Phototherapy - methods; Psoriasis; Ultraviolet radiation; Ultraviolet Rays
• ISSN: 0031-8655; 1751-1097
• DOI: 10.1111/php.12253

Mycosis fungoides (MF) and parapsoriasis (PP) are major dermatologic conditions for which phototherapy continues to be a successful and valuable treatment option. UVA‐1 phototherapy is effective in the management of cutaneous T‐cell mediated diseases. The aim of the study was to evaluate the efficacy and safety of low‐dose UVA‐1 phototherapy for the management of PP/early‐stage MF. A total of 30 patients, diagnosed with MF (n:19) or PP (n:11) were enrolled to the study. All patients were managed with low‐dose UVA‐1 (20 or 30 J cm−2). Response was assessed clinically and immunohistochemically. UVA‐1 treatment led to clinical and histological complete remission (CR) in 11 of 19 MF patients (57.9%), partial remission (PR) in three of 19 (15.8%), after a mean cumulative dose of 1665 (range, 860–3120) J cm−2 and mean number of 73 exposure (range, 43–107) sessions. Five patients with PP (45.5%) showed CR, and PR was observed in six patients with PP (54.5%) after a mean cumulative dose of 1723 (range, 1060–3030) J cm−2 and mean number of 74 exposure (range, 53–101) sessions. We conclude that low‐dose UVA‐1 therapy seems to be an effective, safe, and well‐tolerated treatment option for patients with PP/early‐stage MF. Skin‐directed therapies are currently available treatment options for plaque type PP/early‐stage MF with some limitations, and management of the diseases is still challenging. Ultraviolet A‐1 (340–400 nm) phototherapy was first described in 1978 and it has became a valuable treatment for sclerotic and T‐cell mediated diseases, more deeply penetrates than UVB. This study showed that Low‐dose UVA‐1 therapy seems to be a safe and effective alternative to other therapeutic options in patients with PP/early‐stage MF who do not tolerate or respond to PUVA and UVB therapy, without systemic effect.