"High-dose" UVA1 therapy of widespread plaque-type, nodular, and erythrodermic mycosis fungoides.
BACKGROUND
UVA1 (340 to 400 nm) was found to be effective in the treatment of early-stage mycosis fungoides (MF).


OBJECTIVE
The purpose of this study was to assess the efficacy of UVA1 phototherapy for widespread plaque-type, nodular, and erythrodermic MF.


METHODS
Thirteen patients (8 with stage IB, 4 with IIB, and 1 with III MF) received 100 J/cm(2) UVA1 daily until remission. Four patients also had lesions inaccessible by UVA1 that were considered control lesions. Immunocytologic studies of skin infiltrates and circulating T cells were done before and after the therapy.


RESULTS
Eleven patients showed complete clinical and histologic responses. Two patients had a partial improvement. Unirradiated control lesions never improved. Serious short-term side effects were not recorded. Circulating CD4(+)/CD45RO(+) and CD4(+)/CD95(+) lymphocytes were significantly reduced by the therapy.


CONCLUSIONS
UVA1 therapy is an effective and well-tolerated treatment for advanced MF. The therapeutic relevance of the effects on circulating lymphocytes remains to be established because lesions in nonexposed cutaneous areas did not respond.
Dermatology Department, Azienda Spedali Civili di Brescia, University of Brescia, Italy.
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003873:Dermatitis, Exfoliative / Q000097:blood / Q000209:etiology / Q000532:radiotherapy; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000502:physiology / Q000528:radiation effects; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000097:blood / Q000150:complications / Q000473:pathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D012878:Skin Neoplasms / Q000097:blood / Q000150:complications / Q000473:pathology / Q000532:radiotherapy*; D014467:Ultraviolet Therapy