The World of UV Phototherapy by Chris Cane » Mycosis Fungoides

UVB NB vs PUVA Treatment for Mycosis Fungoides.

Chris Cane — Sun, 31 Jan 2010 05:01:23 +0000

The full article publication is entitled “Efficacy of narrowband UVB vs. PUVA in patients with early-stage mycosis fungoides.” prepared by Ponte P, Serrão V, Apetato M. at the Department of Dermatology, Hospital dos Capuchos, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.

Abstract:

Introduction Mycosis fungoides (MF) is a non-Hodgkin’s T-cell lymphoma of the skin that often begins as limited patches and plaques with slow progression to systemic involvement. Narrowband ultraviolet (UV) B therapy has been proven to be an effective short-term treatment modality for clearing patch-stage MF. The effect of psoralen plus long-wave ultraviolet A (PUVA) in the treatment of patch- and plaque-type MF has also been thoroughly documented. Objectives The purpose of this study was to compare the efficacy and safety of narrowband UVB and PUVA in patients with early-stage MF. Methods We analysed the response to treatment, relapse-free survival and irradiation dose in 114 patients with histologically confirmed early-stage MF (stage IA, IB and IIA). Results A total of 95 patients were treated with PUVA (83.3%) and 19 with narrowband UVB (16.7%). With PUVA, 59 patients (62.1%) had a complete response (CR), 24 (25.3%) had a partial response (PR) and 12 (12.6%) had a failed response. Narrowband UVB led to CR in 12 (68.4%) patients, PR in 5 (26.3%) patients and a failed response in 1 (5.3%) patient.

There were no differences in terms of time to relapse between patients treated with PUVA and those treated with narrowband UVB (11.5 vs. 14.0 months respectively; P = 0.816). No major adverse reactions were attributed to the treatment. Conclusions Our results confirm that phototherapy is a safe, effective and well-tolerated, first-line therapy in patients with early-stage cutaneous T-cell lymphoma, with prolonged disease-free remissions being achieved.

It suggests that narrowband UVB is at least as effective as PUVA for treatment of early-stage MF.

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Narrow-band UVB in the treatment of early stage mycosis fungoides: report of 16 patients.

Chris Cane — Wed, 13 May 2009 13:30:36 +0000

Authors: Ghodsi SZ, Hallaji Z, Balighi K, Safar F, Chams-Davatchi C.

Razi Hospital, Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran.

Although early stage mycosis fungoides (MF) has a generally good prognosis, and long-term survival rates with current therapies (UVB, photochemotherapy, topical nitrogen mustard, electron beam radiotherapy) are similar, there is concern regarding their potential side effects. It has been reported that the same effective UVB dose is safer than PUVA in terms of carcinogenicity, and that it produces fewer side effects. Our aim was to evaluate the effect of narrow-band UVB in the treatment of early stage MF. Sixteen patients (seven males, nine females; mean age, 40 years) with early stage MF received TL-01 phototherapy three times per week using a standard protocol. Twelve patients (75%) had complete response in a mean of 27.9 treatments, three had partial response, and one no response. Upon discontinuation of treatment, six patients with complete response relapsed in a mean time to relapse of 4.5 months. The present study indicates that narrow-band-UVB is an effective treatment modality for early stage MF.

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What’s treated with UVB Narrowband?

Chris Cane — Tue, 14 Apr 2009 10:07:48 +0000

This is a tough question as UVB Narrowband in some ways has become a panacea for many skin challenges. Here’s a partial list of diseases that I’m aware of where UVB Narrowband is one of the treatment options.

Alopecia
Atopic Dermatitis
CTCL (Cutaneous T-Cell Lymphoma)
Dermatitis
Eczema
Graft vs Host Disease (GVHD)
Lichen Planus
Mycosis Fungoides
Parapsoriasis
Pityriasis Lichenoides (PLEVA)
Pityriasis rosea
Pityriasis Rubra Pilaris
Prurigo Nodularis
Pruritus associated with Polycythaemia Vera
Psoriasis
Scleroderma
Sebhorrheic dermatitis
Vitiligo

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Background: UVBNB phototherapy in Dermatology

Chris Cane — Mon, 13 Apr 2009 18:56:21 +0000

Link to entire article << Click Here >>

The first report of the use of ‘phototherapy’ in the treatment of skin disorders dates from 1400 BC from India when patients with vitiligo were given certain plant extracts (whose active ingredients included psoralens) and then exposed to the sun. The real interest in the use of ultraviolet (UV) irradiation in the treatment of various skin diseases started in the 19th century when Niels Finsen received the Nobel Prize (1903) for his therapeutic results with UV irradiation in lupus vulgaris, the only dermatologist ever to be awarded one. This marked the start of modern phototherapy. It was used in thermal stations for the treatment of tuberculosis, in the treatment of leg ulcers in wartime, and various other skin diseases. It was a very long journey from the use of plant extracts and sun exposure to treat vitiligo to the use of oral psoralens and total body UVA-irradiation cabins (PUVA) to treat various skin diseases. In a landmark development, in 1974 Parrish et al reported the useful role of high intensity UVA tubes in combination with oral psoralens in the treatment of psoriasis leading to what is now known as PUVA therapy.

The history of UVB phototherapy is not as old as the history of photochemotherapy. Wiskemann introduced irradiation cabin with broad band UVB tubes in 1978 for the treatment of psoriasis and uremic pruritus. However, broad band UVB phototherapy was less efficient for treating psoriasis than PUVA and so never achieved popularity. The breakthrough came after 1988 when narrow-band UVB (NB-UVB) phototherapy was introduced for the treatment of psoriasis by van Weelden et al and Green et al.

Link to entire article << Click Here >>

Excerpted from an article by: Sunil Dogra, Amrinder Jit Kanwar, Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education & Research, Chandigarh, India

Correspondence Address:
Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education & Research, Chandigarh – 160102, India
ajkanwar@sify.com

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