title: PUVA phototherapy-induced secondary amyloidosis in patients with mycosis fungoides: a rare adverse effect of phototherapy.
abstract: OBJECTIVE
  Amyloidosis is a common disorder in adults. Secondary amyloidosis in patients with mycosis fungoides (MF) after photochemotherapy with 8-methoxypsoralen followed by ultraviolet A (PUVA) treatment has not been reported. Our aim is to describe the clinical and histological features of PUVA phototherapy-induced secondary amyloidosis.
  
  
  METHODS
  Sixty-one patients with MF treated with PUVA phototherapy were analyzed clinically and pathologically and by staining with Congo red and crystal violet.
  
  
  RESULTS
  Of 61 patients, 5 met the study criteria. Secondary amyloidosis was detected in 5 patients treated with PUVA. The secondary amyloidosis appeared after a mean of 56 exposures (range: 30--81) and a mean cumulative PUVA radiation dose of 131.7 J/cm2 (range: 31-305.5). The mean follow-up duration from the date of occurrence of the secondary amyloidosis was 18.2 weeks (range: 10-30). Histologically, vacuolar interface changes, colloid bodies, and melanophages were seen in all 5 patients. There were 4 patients who had perivascular lymphocytic infiltration and 1 patient had lichenoid lymphocytic infiltration.
  
  
  CONCLUSIONS
  It should be noted that secondary amyloidosis can be present in patients who have been treated with PUVA therapy and it can be a result of the apoptotic effect of PUVA on the basal keratinocytes.
authors.affiliation: Department of Pathology, Medeniyet University Göztep Training and Research Hospital, İstanbul,  Turkey. ebruzemheri@gmail.com
authors.forename: Itir Ebru
authors.initials: IE
authors.lastname: Zemheri
authors.forename: Sidika Seyma
authors.initials: SS
authors.lastname: Ozkanli
authors.forename: Ilkin
authors.initials: I
authors.lastname: Zindanci
authors.forename: Serkan
authors.initials: S
authors.lastname: Senol
authors.forename: Ozue
authors.initials: O
authors.lastname: Akbulak
authors.forename: Filiz
authors.initials: F
authors.lastname: Topaloğlu Demir
mesh_terms: D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000188:drug therapy*; D011701:PUVA Therapy / Q000009:adverse effects*