Plaque-Phase Mycosis Fungoides Treated with Photodynamic Therapy: Results from 12 Patients

Fernández-Guarino, M.; Harto, A.; Pérez-García, B.; Montull, C.; De Las Heras, E.; Jaén, P.

doi:10.1016/S1578-2190(10)70717-4

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Abstract

Background

Recent years have seen an increase in the off-label use of photodynamic therapy for the treatment of a variety of skin diseases. Plaque-phase mycosis fungoides is among the most promising possibilities for the use of this treatment.

Objectives

To evaluate the treatment of plaque-phase mycosis fungoides with photodynamic therapy and compare the results obtained using fluorescence photography.

Material and methods

We performed a prospective, descriptive, observational study. Twelve patients with 24 lesions were treated with topical methyl aminolevulinate (MAL) under an occlusive dressing for 3 hours, followed by 8 minutes of red light (630 nm, 37 J/ cm2; Aktilite).

Results

Six patients had a complete response, 5 a partial response, and 1 did not respond to treatment. A mean of 5.7 sessions was applied and no side effects were reported. Treatment tolerance was excellent.

Conclusions

Photodynamic therapy with MAL appears to be a good treatment option for patients with plaque-phase mycosis fungoides with a small number of lesions.

Keywords:

Mycosis fungoides

Photodynamic therapy

Methyl aminolevulinate

Resumen

Introducción

La terapia fotodinámica (TFD) está siendo desarrollada en los últimos años en dermatosis diferentes de las aprobadas para su uso. Entre todas ellas, la micosis fungoide (MF) en estadio de placas es una de las más prometedoras.

Objetivos

Evaluar los resultados en el tratamiento de la MF en placas con TFD y correlacionarlos con la fotografía de fluorescencia.

Material y métodos

Llevamos a cabo un estudio prospectivo, descriptivo y observacional. Se seleccionaron un total de 12 pacientes con 24 lesiones que fueron tratados con metilaminolevulinato (MAL) tópico ocluido tres horas y luz roja (630 nm, 37 J/cm2, 8 min, Aktilite®).

Resultados

Un total de 6 pacientes obtuvo respuesta completa, 5 pacientes alcanzaron respuesta parcial y uno no respondió al tratamiento. La media de sesiones aplicadas fue de 5,7 y no se recopilaron efectos secundarios. La tolerancia fue excelente.

Conclusiones

La TFD con MAL parece una buena alternativa terapéutica para los pacientes con MF en placas con escaso número de lesiones.

Palabras clave:

Micosis fungoide

Terapia fotodinámica

Metilaminolevulínico

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