Plaque stage mycosis fungoides treated with bexarotene at low dosage and UVB-NB.
Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma (CTCL), a non-Hodgkin lymphoma characterized by proliferation of atypical epidermotrophic helper/memory T cells in the skin. Therapeutic management includes topical therapy such as topical corticosteroids, topical chemotherapy or phototherapy; or systemic therapy such as photochemotherapy (psoralen and ultraviolet A [PUVA]), extracorporeal phototherapy, radiation, and mono or polychemotherapy. Herein we report one case of MF unresponsive to conventional therapy, subsequently treated with bexarotene and narrow-band ultraviolet B (UVB-NB). Bexarotene belongs to a new subclass of retinoids, binding primarily the nuclear hormone receptors RXRs. Bexarotene has the same effect as its natural counterpart: 9-cis-retinoic acid. Bexarotene may be used alone or in association with interferon alfa, interferon gamma, extracorporeal photophoresis and PUVA. We utilized 75 mg/day of bexarotene associated with 0.3 J/cm(2) UVB-NB as an initial dose. The sessions were three times weekly and the irradiation was increased by 30% at each session to reach a maximum of 1.6 J/cm(2). After 8 week treatment, clinical lesions markedly improved without recording hypercholesterolemia or hypothyroidism. During the follow-up no relapses were detected. We suggest that the combined therapy UVB-NB and bexarotene may be considered as an alternative treatment to PUVA and bexarotene.
D'Acunto
Carmine
C
Dermatology, Department of Internal Medicine, Geriatrics and Nephrologic Diseases, University of Bologna, Bologna, Italy.
Gurioli
Carlotta
C
Neri
Iria
I
D000368:Aged; D016588:Anticarcinogenic Agents / Q000627:therapeutic use*; D000077610:Bexarotene; D005260:Female; D006801:Humans; D009182:Mycosis Fungoides / Q000473:pathology / Q000628:therapy*; D011701:PUVA Therapy; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy*; D013764:Tetrahydronaphthalenes / Q000627:therapeutic use*
D016588:Anticarcinogenic Agents; D013764:Tetrahydronaphthalenes; D000077610:Bexarotene