Elise A Olsen1, Emilia Hodak2, Thomas Anderson3, Joi B Carter4, Marsha Henderson5, Kevin Cooper6, Henry W Lim5. 1. Departments of Dermatology and Medicine, Duke University Medical Center, Durham, North Carolina. Electronic address: elise.olsen@dm.duke.edu. 2. Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Department of Dermatology, University of Michigan, Ann Arbor, Michigan. 4. Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts. 5. Department of Dermatology, Henry Ford Hospital, Detroit, Michigan. 6. Department of Dermatology, Case Western Reserve University, Cleveland, Ohio.
Abstract
BACKGROUND: Ultraviolet light (UVL) is a long established treatment for mycosis fungoides (MF) and Sézary syndrome (SS), subtypes of cutaneous T-cell lymphoma (CTCL). Treatments have traditionally included broadband, narrowband ultraviolet B light (UVB) and psoralen plus ultraviolet A light photochemotherapy (PUVA), but more recently, treatment options have expanded to include UVA1 and excimer laser. UVL is used either as monotherapy or as an adjuvant to systemic therapy, demonstrating efficacy in many cases that equal or surpass systemic medications. Despite its utility and duration of use, the current practice of using UVL guidelines for psoriasis to treat patients with MF/SS is problematic because the goals of prolonging survival and preventing disease progression are unique to CTCL compared to psoriasis. OBJECTIVES: We sought to develop separate guidelines for phototherapy for MF/SS for both clinical practice and for clinical trials. METHODS: Literature review and cutaneous lymphoma expert consensus group recommendations. RESULTS: This paper reviews the published literature for UVB and UVA/PUVA in MF/SS and suggests practical standardized guidelines for their use. LIMITATIONS: New standardization of phototherapy. CONCLUSIONS: These guidelines should allow the comparison of results with phototherapy in MF/SS across different stages of patients, centers, and in combination with other agents in practice and in clinical trials.
BACKGROUND: Ultraviolet light (UVL) is a long established treatment for mycosis fungoides (MF) and Sézary syndrome (SS), subtypes of cutaneous T-cell lymphoma (CTCL). Treatments have traditionally included broadband, narrowband ultraviolet B light (UVB) and psoralen plus ultraviolet A light photochemotherapy (PUVA), but more recently, treatment options have expanded to include UVA1 and excimer laser. UVL is used either as monotherapy or as an adjuvant to systemic therapy, demonstrating efficacy in many cases that equal or surpass systemic medications. Despite its utility and duration of use, the current practice of using UVL guidelines for psoriasis to treat patients with MF/SS is problematic because the goals of prolonging survival and preventing disease progression are unique to CTCL compared to psoriasis. OBJECTIVES: We sought to develop separate guidelines for phototherapy for MF/SS for both clinical practice and for clinical trials. METHODS: Literature review and cutaneous lymphoma expert consensus group recommendations. RESULTS: This paper reviews the published literature for UVB and UVA/PUVA in MF/SS and suggests practical standardized guidelines for their use. LIMITATIONS: New standardization of phototherapy. CONCLUSIONS: These guidelines should allow the comparison of results with phototherapy in MF/SS across different stages of patients, centers, and in combination with other agents in practice and in clinical trials.
Authors: Pablo Vieyra-Garcia; Regina Fink-Puches; Stefanie Porkert; Roland Lang; Sophie Pöchlauer; Gudrun Ratzinger; Adrian Tanew; Sylvia Selhofer; Sator Paul-Gunther; Angelika Hofer; Alexandra Gruber-Wackernagel; Franz Legat; Vijaykumar Patra; Franz Quehenberger; Lorenzo Cerroni; Rachael Clark; Peter Wolf Journal: JAMA Dermatol Date: 2019-05-01 Impact factor: 10.282
Authors: P Quaglino; H M Prince; R Cowan; M Vermeer; E Papadavid; M Bagot; O Servitjie; E Berti; E Guenova; R Stadler; C Querfeld; A M Busschots; E Hodak; A Patsatsi; J Sanches; M Maule; J Yoo; M Kevin; P Fava; S Ribero; L Zocchi; M Rubatto; M T Fierro; U Wehkamp; M Marshalko; C Mitteldorf; O Akilov; P Ortiz-Romero; T Estrach; L Vakeva; P A Enz; M Wobser; M Bayne; C Jonak; M Rubeta; A Forbes; A Bates; M Battistella; R Amel-Kashipaz; B Vydianath; A Combalia; E Georgiou; E Hauben; E K Hong; M Jost; R Knobler; I Amitay-Laish; D Miyashiro; J Cury-Martins; X Martinez; C Muniesa; H Prag-Naveh; A Stratigos; V Nikolaou; K Quint; C Ram-Wolff; K Rieger; R Stranzenbach; Á Szepesi; S Alberti-Violetti; E Felicity; L Cerroni; W Kempf; S Whittaker; R Willemze; Y Kim; J J Scarisbrick Journal: Br J Dermatol Date: 2021-02-18 Impact factor: 9.302