title: The role of phototherapy in cutaneous chronic graft-vs-host disease: a retrospective study and review of the literature.
abstract: OBJECTIVE
  Cutaneous chronic graft-vs-host disease (GVHD) is a common complication of hematopoietic stem cell transplantation. Phototherapy is a therapeutic option for patients with skin involvement and for those who require high doses of corticosteroids. We analyze the cases treated in our department and review the literature.
  
  
  METHODS
  All patients with GVHD treated with phototherapy in the dermatology department of Hospital Universitario y Politécnico la Fe in Valencia, Spain between March 2011 and October 2014 were identified. Data were gathered retrospectively.
  
  
  RESULTS
  There were 16 patients: 10 treated with psoralen-UV-A and 6 with narrowband-UV-B. Complete response was achieved in 9 patients and partial response in 7; 2 patients with partial responses relapsed after treatment. Ten patients were able to decrease their dose of corticosteroids during treatment, and a further 3 decreased the number of other immunosuppressant drugs. No serious adverse effects occurred.
  
  
  CONCLUSIONS
  Phototherapy is a good therapeutic option for patients with chronic GVHD with extensive cutaneous involvement, as well as for those who fail to respond to topical treatment or who have become steroid-dependent. The main benefits are that, as the treatment targets the skin, it reduces corticosteroid requirements and has a good safety profile. Treatment must be individualized and, in our experience, both the initial dose and the maximum dose per session can be lower than for other diseases.
authors.affiliation: Servicio de Dermatología, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, España. Electronic address: roseta999@hotmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Ballester-Sánchez
authors.affiliation: Servicio de Dermatología, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, España.
authors.forename: M Á
authors.initials: MÁ
authors.lastname: Navarro-Mira
authors.affiliation: Servicio de Dermatología, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, España.
authors.forename: B
authors.initials: B
authors.lastname: de Unamuno-Bustos
authors.affiliation: Servicio de Dermatología, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, España.
authors.forename: C
authors.initials: C
authors.lastname: Pujol-Marco
authors.affiliation: Servicio de Hematología, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, España.
authors.forename: J
authors.initials: J
authors.lastname: Sanz-Caballer
authors.affiliation: Servicio de Dermatología, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, España.
authors.forename: R
authors.initials: R
authors.lastname: Botella-Estrada
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D064591:Allografts; D002675:Child, Preschool; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005260:Female; D005363:Ficusin / Q000009:adverse effects / Q000627:therapeutic use; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000209:etiology / Q000532:radiotherapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy / Q000009:adverse effects; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D014467:Ultraviolet Therapy / Q000009:adverse effects
chemical_list: D000305:Adrenal Cortex Hormones; D017319:Photosensitizing Agents; D005363:Ficusin
keywords: Cutaneous chronic graft-vs-host disease; Enfermedad injerto contra huésped crónica cutánea; Fototerapia; Narrowband–UV-B; PUVA; Phototherapy; Psoralen–UV-A; UVB-BE