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Narrowband UVB phototherapy for early-stage mycosis fungoides: evaluation of clinical and histopathological changes.
J Eur Acad Dermatol Venereol. 2006 Aug; 20(7):804-9.JE

Abstract

BACKGROUND

Early-stage (IA, IB, IIA) mycosis fungoides (MF) has long been treated with various agents including topical potent steroids, nitrogen mustard, carmustine, oral psoralen plus UVA (PUVA), broadband UVB, electron-beam radiotherapy, interferon-alpha and retinoids. However, each of these modalities is associated with various side-effects. Narrowband UVB (NB-UVB) therapy has the same effect but is safer to use than the other methods.

OBJECTIVE

Our purpose in this prospective study was to determine the effects of NB-UVB in early-stage MF both clinically and histopathologically.

MATERIALS AND METHODS

Twenty-three patients (20 men, three women, aged 27-78 years) with clinically and histologically confirmed MF were enrolled. Patients received NB-UVB therapy three times a week. Clinical and histological responses, cumulative doses, total number of treatments, side-effects and duration of remission period were noted.

RESULTS

Six patients had stage IA MF, 15 patients stage IB and two patients stage IIA. Eighteen patients had patch stage and five patients had plaque stage histopathologically. All of the patients in the patch group had a complete response (CR). In the plaque group, three patients (60%) had a CR and two (40%) had partial (PR) or no clinical response (NR). The clinical response between patch and plaque groups was statistically significant. Regarding the histopathological findings, 17 (94.4%) had complete clearing and only one (5.6%) patient had a partial improvement in the patch group. In the plaque group, one (20%) patient had complete clearing and four (80%) patients had partial or no improvement. The difference between the two groups was statistically significant. In the patch group, the mean cumulative dose was 90.15 J/cm(2) and the mean number of treatments was 35.33. In the plaque group, the mean cumulative dose was 90.67 J/cm(2) and the mean total number of treatments was 39.40. The differences were not statistically significant, either between the mean cumulative dose or the mean number of treatments. The mean duration of follow-up was 10.87 months (range 1-25 months). Only one of the patients had a relapse.

CONCLUSIONS

NB-UVB therapy for patients with early-stage MF is an effective and safe treatment with the effect lasting for months. We suggest that clinical clearance correlates with histological improvement except for patients in the plaque stage.

Authors+Show Affiliations

Dermatology Clinic, Sisli Etfal Research and Training Hospital, Istanbul, Turkey. goncagokdemir@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

16898902

Citation

Gökdemir, G, et al. "Narrowband UVB Phototherapy for Early-stage Mycosis Fungoides: Evaluation of Clinical and Histopathological Changes." Journal of the European Academy of Dermatology and Venereology : JEADV, vol. 20, no. 7, 2006, pp. 804-9.
Gökdemir G, Barutcuoglu B, Sakiz D, et al. Narrowband UVB phototherapy for early-stage mycosis fungoides: evaluation of clinical and histopathological changes. J Eur Acad Dermatol Venereol. 2006;20(7):804-9.
Gökdemir, G., Barutcuoglu, B., Sakiz, D., & Köşlü, A. (2006). Narrowband UVB phototherapy for early-stage mycosis fungoides: evaluation of clinical and histopathological changes. Journal of the European Academy of Dermatology and Venereology : JEADV, 20(7), 804-9.
Gökdemir G, et al. Narrowband UVB Phototherapy for Early-stage Mycosis Fungoides: Evaluation of Clinical and Histopathological Changes. J Eur Acad Dermatol Venereol. 2006;20(7):804-9. PubMed PMID: 16898902.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Narrowband UVB phototherapy for early-stage mycosis fungoides: evaluation of clinical and histopathological changes. AU - Gökdemir,G, AU - Barutcuoglu,B, AU - Sakiz,D, AU - Köşlü,A, PY - 2006/8/11/pubmed PY - 2007/1/16/medline PY - 2006/8/11/entrez SP - 804 EP - 9 JF - Journal of the European Academy of Dermatology and Venereology : JEADV JO - J Eur Acad Dermatol Venereol VL - 20 IS - 7 N2 - BACKGROUND: Early-stage (IA, IB, IIA) mycosis fungoides (MF) has long been treated with various agents including topical potent steroids, nitrogen mustard, carmustine, oral psoralen plus UVA (PUVA), broadband UVB, electron-beam radiotherapy, interferon-alpha and retinoids. However, each of these modalities is associated with various side-effects. Narrowband UVB (NB-UVB) therapy has the same effect but is safer to use than the other methods. OBJECTIVE: Our purpose in this prospective study was to determine the effects of NB-UVB in early-stage MF both clinically and histopathologically. MATERIALS AND METHODS: Twenty-three patients (20 men, three women, aged 27-78 years) with clinically and histologically confirmed MF were enrolled. Patients received NB-UVB therapy three times a week. Clinical and histological responses, cumulative doses, total number of treatments, side-effects and duration of remission period were noted. RESULTS: Six patients had stage IA MF, 15 patients stage IB and two patients stage IIA. Eighteen patients had patch stage and five patients had plaque stage histopathologically. All of the patients in the patch group had a complete response (CR). In the plaque group, three patients (60%) had a CR and two (40%) had partial (PR) or no clinical response (NR). The clinical response between patch and plaque groups was statistically significant. Regarding the histopathological findings, 17 (94.4%) had complete clearing and only one (5.6%) patient had a partial improvement in the patch group. In the plaque group, one (20%) patient had complete clearing and four (80%) patients had partial or no improvement. The difference between the two groups was statistically significant. In the patch group, the mean cumulative dose was 90.15 J/cm(2) and the mean number of treatments was 35.33. In the plaque group, the mean cumulative dose was 90.67 J/cm(2) and the mean total number of treatments was 39.40. The differences were not statistically significant, either between the mean cumulative dose or the mean number of treatments. The mean duration of follow-up was 10.87 months (range 1-25 months). Only one of the patients had a relapse. CONCLUSIONS: NB-UVB therapy for patients with early-stage MF is an effective and safe treatment with the effect lasting for months. We suggest that clinical clearance correlates with histological improvement except for patients in the plaque stage. SN - 0926-9959 UR - https://www.unboundmedicine.com/medline/citation/16898902/Narrowband_UVB_phototherapy_for_early_stage_mycosis_fungoides:_evaluation_of_clinical_and_histopathological_changes_ L2 - https://doi.org/10.1111/j.1468-3083.2006.01635.x DB - PRIME DP - Unbound Medicine ER -