"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.
Zane
C
C
Dermatology Department, Azienda Spedali Civili di Brescia, University of Brescia, Italy.
Leali
C
C
Airò
P
P
De Panfilis
G
G
Pinton
P C
PC
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