A phase II placebo-controlled study of photodynamic therapy with topical hypericin and visible light irradiation in the treatment of cutaneous T-cell lymphoma and psoriasis.
BACKGROUND
Hypericin is a known photodynamic agent that has been demonstrated to induce apoptosis in normal and malignant B and T lymphocytes, and has potential to treat benign and malignant disorders of the skin, including psoriasis and cutaneous T-cell lymphoma.


OBJECTIVE
We wished to test whether topical hypericin was an effective, safe, and well-tolerated therapy for patch or plaque phase mycosis fungoides and for plaque psoriasis.


METHODS
We conducted a phase II placebo-controlled clinical study in patients who had either patch or plaque phase mycosis fungoides or plaque type psoriasis vulgaris. Representative lesions were treated twice weekly for 6 weeks with topically applied hypericin or placebo followed 24 hours later by exposure to visible light at 8 to 20 J/cm(2).


RESULTS
After 6 weeks of twice-weekly therapy, several concentrations of hypericin resulted in the significant improvement of treated skin lesions among the majority of patients with cutaneous T-cell lymphoma and psoriasis whereas the placebo vehicle was ineffective.


CONCLUSIONS
The clinical trial involved a small number of patients.


CONCLUSIONS
Overall, the data from this study support the conclusion that topical hypericin/visible light photodynamic therapy is an effective and well-tolerated alternative to standard psoralen plus ultraviolet A treatment of these disorders.
Rook
Alain H
AH
University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104, USA. arook@mail.med.upenn.edu
Wood
Gary S
GS
Duvic
Madeleine
M
Vonderheid
Eric C
EC
Tobia
Alfonso
A
Cabana
Bernard
B
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000873:Anthracenes; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008027:Light; D016410:Lymphoma, T-Cell, Cutaneous / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010569:Perylene / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D010778:Photochemotherapy / Q000009:adverse effects / Q000379:methods*; D010789:Phototherapy / Q000009:adverse effects; D010919:Placebos; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy*; D012878:Skin Neoplasms / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
D000873:Anthracenes; D000970:Antineoplastic Agents; D010919:Placebos; D010569:Perylene; C004965:hypericin