[Treatment of mycosis fungoides with PUVA and bexarotene].
BACKGROUND
The combined use of bexarotene and PUVA is a treatment that is currently being investigated. In this paper, six patients treated with this combination are presented.


OBJECTIVE
To assess the efficacy and safety of treatment with PUVA + bexarotene in patients with mycosis fungoides (MF). Patients, material and methods. Six patients diagnosed with MF in different stages, who received three sessions of PUVA treatment a week (initially 2.35 J/cm 2, with progressive increases to a maximum of 23.5 J/cm 2) + bexarotene (initial dose 300 mg/m 2/day, decreasing to 200, 150 or 75 mg/m 2 if signs of toxicity appeared). All received atorvastatin.


RESULTS
Stage at the start of treatment: two patients IIb, one patient Ib with B2 blood involvement, two patients Ib, one patient Ia. Five of the six patients responded to the treatment (three full remissions [FR], two partial remissions [PR]). One patient did not respond. In those in whom FR was achieved, the time required for the response was 10, 20 and 24 weeks. All presented with hypertriglyceridemia (maximum 1194 mg/ dL). It was necessary to administer thyroid hormone supplements to four of the patients. Two of them had alterations in the hepatic biochemistry values, and two others presented with alterations in the muscle profile analysis.


CONCLUSIONS
The combination of PUVA and bexarotene is a safe and effective treatment for MF. It will be necessary to await the results of the clinical trials currently underway to see if their combined use is better than treatment with PUVA alone. The response rate (RR) was 86 % (three FR and two PR out of six patients).
Ortiz-Romero
Pablo L
PL
Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España. portiz.hdoc@salud.madrid.org
Sánchez-Largo
Maria Elena
ME
Sanz
Henar
H
García-Romero
Diana
D
Rosales
Belén
B
Valverde
Ricardo
R
Arrue
Itzíar
I
Polo
Isabel
I
Ruiz
Diana
D
Fernández-Herrera
Jesús
J
Vanaclocha
Francisco
F
D000328:Adult; D000368:Aged; D000077610:Bexarotene; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000188:drug therapy*; D011701:PUVA Therapy; D012878:Skin Neoplasms / Q000188:drug therapy*; D013764:Tetrahydronaphthalenes / Q000627:therapeutic use*
D013764:Tetrahydronaphthalenes; D000077610:Bexarotene