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Evaluation of patients receiving narrow-band ultraviolet B phototherapy for early stage Mycosis fungoides

Yıl 2024, , 110 - 113, 22.01.2025
https://doi.org/10.20492/aeahtd.1472165

Öz

Aim: To examine the demographic characteristics, disease prevalence, histopathological findings, phototherapy treatment data and responses of patients receiving narrow-band ultraviolet B (nbUVB) phototherapy for early-stage mycosis fungoides (MF).
Material and methods: Patients with a clinically and histopathologically confirmed diagnosis of MF who received dbUVB monotherapy for at least 12 weeks in the phototherapy unit of a tertiary healthcare institution between February 2020 and February 2024 were included in this study. The evaluation variables for the study were age, gender, presence of pruritus, previous treatments, time to diagnosis, body involvement areas, histopathological findings, total dose of phototherapy, number of phototherapy sessions, phototherapy response, phototherapy side effects. The variables were analysed statistically.
Results: Data of 50 patients were included in the study. The mean age of the patients was 50.1±17.8 years. 50% (n=25) of the patients were male and 50% (n=25) were female. The mean duration of diagnosis was 75.37±9.05 months. Itching symptom was reported in 30% (n=15) of the patients. 58% (n=29) of the patients had a complete response to treatment. The mean duration of treatment was 14.2±7.2 months. Patients received a median of 121 (36-324) sessions of dbUVB treatment. 65.6% (n=21) of stage 1A patients and 44.4% (n=8) of stage 1B patients benefited from the treatment. Mild erythema and pruritus side effects were observed in 42% (n=21) of the patients.
Conclusion: NbUVB phototherapy is an effective treatment modality for early stage MF with a reliable side effect profile.

Kaynakça

  • 1- Willemze R, Cerroni L, Kempf W, Berti E, Facchetti F, Swerdlow SH, et al. The 2018 update of the WHO-EORTC classification for primary cutaneous lymphomas. Blood. 2019;133(16):1703-1714.
  • 2- Amorim GM, Niemeyer-Corbellini JP, Quintella DC, Cuzzi T, Ramos-E-Silva M. Clinical and epidemiological profile of patients with early stage mycosis fungoides. An Bras Dermatol. 2018;93(4):546-552.
  • 3- Beyer M, Möbs M, Humme D, Sterry W. Pathogenesis of Mycosis fungoides. J Dtsch Dermatol Ges. 2011;9(8):594- 598.
  • 4- Cerroni L. Mycosis fungoides-clinical and histopathologic features, differential diagnosis, and treatment. Semin Cutan Med Surg. 2018;37(1):2-10.
  • 5- Alsayyah A. Is it mycosis fungoides? A comprehensive guide to reaching the diagnosis and avoiding common pitfalls. Ann Diagn Pathol. 2020;47:151546.
  • 6- Izban KF, Hsi ED, Alkan S. Immunohistochemical analysis of mycosis fungoides on paraffin-embedded tissue sections. Mod Pathol. 1998 Oct;11(10):978-82.
  • 7- Olsen E, Vonderheid E, Pimpinelli N, Willemze R, Kim Y, Knobler R, et al. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC). Blood 2007;110:1713–22.
  • 8- Ibrahim MA, Eltayeb N, Ibrahim MM, Nassar A, Daruish M, El-Zimaity M, et al. Suggested Guidelines for the Treatment of Mycosis Fungoides in Countries with Limited Resources. Dermatol Res Pract. 2023;2023:1360740.
  • 9- Gökdemir G, Barutcuoglu B, Sakiz D, Köşlü A. Narrowband UVB phototherapy for early-stage mycosis fungoides: evaluation of clinical and histopathological changes. J Eur Acad Dermatol Venereol. 2006;20(7):804-9.
  • 10- Atci T, Baykal C. Efficacy of narrow-band ultraviolet-B therapy in patch-stage mycosis fungoides: A clinical study and review of the literature. Photodermatol Photoimmunol Photomed. 2020 Jul;36(4):271-277.
  • 11- Mehta D, Lim HW. Ultraviolet B Phototherapy for Psoriasis: Review of Practical Guidelines. Am J Clin Dermatol. 2016;17(2):125-33.
  • 12- Fatima S, Siddiqui S, Tariq MU, Ishtiaque H, Idrees R, Ahmed Z, et al. Mycosis Fungoides: A Clinicopathological Study of 60 Cases from a Tertiary Care Center. Indian J Dermatol. 2020;65(2):123-129.
  • 13- Clark C, Dawe RS, Evans AT, Lowe G, Ferguson J. Narrowband TL-01 Phototherapy for Patch-Stage Mycosis Fungoides. Arch Dermatol. 2000;136(6):748–752.
  • 14- Hofer A, Cerroni L, Kerl H, Wolf P. Narrowband (311-nm) UV-B therapy for small plaque parapsoriasis and early-stage mycosis fungoides. Arch Dermatol. 1999;135(11):1377- 80.
  • 15- Ponte P, Serrao V, Apetato M. Efficacy of narrowband UVB vs. PUVA in patients with early-stage mycosis fungoides. J Eur Acad Dermatol Venereol. 2010;24:716-721.
  • 16- Boztepe G, Sahin S, Ayhan M, Erkin G, Kilemen F. Narrowband ultraviolet B phototherapy to clear and maintain clearance in patients with mycosis fungoides. J Am Acad Dermatol. 2005; 53:242-246.
  • 17- Dereure O, Picot E, Comte C, Bessis D, Guillot B. Treatment of early stages of mycosis fungoides with narrowband ultraviolet B. A clinical, histological and molecular evaluation of results. Dermatology. 2009;218:1-6.
  • 18- Diederen PV, van Weelden H, Sanders CJ, Toonstra J, van Vloten WA. Narrowband UVB and psoralen-UVA in the treatment of early-stage mycosis fungoides: a retrospective study. J Am Acad Dermatol. 2003;48:215-219.
  • 19- Gathers RC, Scherschun L, Malick F, Fivenson DP, Lim HW. Narrowband UVB phototherapy for early-stage mycosis fungoides. J Am Acad Dermatol. 2002;47:191-197.
  • 20- Pavlotsky F, Barzilai A, Kasem R, Shpiro D, Trau H. UVB in the management of early stage mycosis fungoides. J Eur Acad Dermatol Venereol. 2006 May;20(5):565-72.
  • 21- Jang MS, Baek JW, Park JB, Kang DY, Kang JS, Suh KS, et al. Narrowband ultraviolet B phototherapy of early stage mycosis fungoides in korean patients. Ann Dermatol. 2011 Nov;23(4):474-80.
  • 22- Coronel-Pérez IM, Carrizosa-Esquivel AM, Camacho-Martínez F. Tratamiento con UVB de banda estrecha de los estadios iniciales de la micosis fungoide. Estudio de 23 pacientes [Narrow band UVB therapy in early stage mycosis fungoides. A study of 23 patients]. Actas Dermosifiliogr. 2007 May;98(4):259-64.
  • 23- Reyes V, Bosio BM, Ruiz LA, Kurpis M. Treatment of early stages of mycosis fungoides with narrow band UVB the mycosis fungoides in early stage. Med Cutan Iber Lat Am. 2019;47(1):29-33.
  • 24- Elcin G, Duman N, Karahan S, Ersoy-Evans S, Erkin G, Karaduman A, et al. Long-term follow-up of early mycosis fungoides patients treated with narrowband ultraviolet B phototherapy. J Dermatolog Treat. 2014;25:268-273
  • 25- Hodak E, Geskin L, Guenova E, Ortiz-Romero PL, Willemze R, Zheng J, et al. Real-Life Barriers to Diagnosis of Early Mycosis Fungoides: An International Expert Panel Discussion. Am J Clin Dermatol. 2023 Jan;24(1):5-14.
  • 26- Ko MJ, Yang JY, Wu HY, Hu FC, Chen SI, Tsai PJ, et al. Narrowband ultraviolet B phototherapy for patients with refractory uraemic pruritus: a randomized controlled trial. Br J Dermatol. 2011 ;165(3):633-9.
  • 27- Trautinger F, Knobler R, Willemze R, Peris K, Stadler R, Laroche L, et al. EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome. Eur J Cancer. 2006;42:1014-1030.
  • 28- Gara S, Litaiem N, Bacha T, Jmour Y, Zeglaoui F. Maintenance Phototherapy for the Treatment of Early-stage Mycosis Fungoides. J Clin Aesthet Dermatol. 2021;14(10):25- 26.

Erken evre Mikozis fungoides nedeniyle darband ultraviyole B fototerapisi alan hastaların değerlendirilmesi

Yıl 2024, , 110 - 113, 22.01.2025
https://doi.org/10.20492/aeahtd.1472165

Öz

ÖZET
Amaç: Bu çalışmanın amacı, erken evre Mikozis fungoides (MF) nedeniyle darband ultraviyole B (dbUVB) fototerapisi alan hastaların demografik özellikleri, hastalık yaygınlıkları, histopatolojik bulguları, fototerapi tedavi verileri ve yanıtlarının incelenmesidir.
Gereç ve yöntem: Bu çalışmaya Şubat 2020 ile Şubat 2024 yılları arasında üçüncü basamak bir sağlık kuruluşunun fototerapi ünitesinde, klinik ve histopatolojik olarak MF tanısı doğrulanmış ve en az 12 hafta dbUVB monoterapisi alan hastalar kabul edildi. Çalışma için değerlendirme değişkenleri; yaş, cinsiyet, kaşıntı varlığı, daha önceki tedaviler, tanı alma süresi, vücut tutulum alanları, histopatolojik bulgular, fototerapi toplam dozu, fototerapi seans sayısı, fototerapi yanıtı, fototerapi yan etkileri olarak seçilmiştir. Değişkenler istatistiksel olarak analiz edilmişti.
Bulgular: Çalışmaya 50 hastanın verileri dahil edildi. Hastaların yaş ortalaması 50,1±17,8’di Hastaların %50’si (n=25) erkekti, %50’si (n=25) kadındı. Hastaların ortalama tanı alma süreleri 75,37±9,05 aydı. Kaşıntı semptomu hastaların %30’unda (n=15) bildirilmişti. Hastaların %58’i (n=29) tedaviden tam yanıt aldı. Hastaların ortalama tedavi süreleri 14,2±7,2 aydı. Hastalar median 121 (36-324) seans dbUVB tedavisi almıştı. Evre 1A olan hastaların %65,6’sı (n=21), Evre 1B olan hastaların %44,4’ü (n=8) tedaviden fayda görmüştü. Hastaların %42’sinde (n=21) hafif eritem ve pruritus yan etkisi görülmüştü.
Sonuç: DbUVB fototerapisi erken evre MF için efektif ve yan etki profili güvenilir bir tedavi yöntemidir.
Anahtar kelimeler: kutanöz, lenfoma, tedavi

Kaynakça

  • 1- Willemze R, Cerroni L, Kempf W, Berti E, Facchetti F, Swerdlow SH, et al. The 2018 update of the WHO-EORTC classification for primary cutaneous lymphomas. Blood. 2019;133(16):1703-1714.
  • 2- Amorim GM, Niemeyer-Corbellini JP, Quintella DC, Cuzzi T, Ramos-E-Silva M. Clinical and epidemiological profile of patients with early stage mycosis fungoides. An Bras Dermatol. 2018;93(4):546-552.
  • 3- Beyer M, Möbs M, Humme D, Sterry W. Pathogenesis of Mycosis fungoides. J Dtsch Dermatol Ges. 2011;9(8):594- 598.
  • 4- Cerroni L. Mycosis fungoides-clinical and histopathologic features, differential diagnosis, and treatment. Semin Cutan Med Surg. 2018;37(1):2-10.
  • 5- Alsayyah A. Is it mycosis fungoides? A comprehensive guide to reaching the diagnosis and avoiding common pitfalls. Ann Diagn Pathol. 2020;47:151546.
  • 6- Izban KF, Hsi ED, Alkan S. Immunohistochemical analysis of mycosis fungoides on paraffin-embedded tissue sections. Mod Pathol. 1998 Oct;11(10):978-82.
  • 7- Olsen E, Vonderheid E, Pimpinelli N, Willemze R, Kim Y, Knobler R, et al. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC). Blood 2007;110:1713–22.
  • 8- Ibrahim MA, Eltayeb N, Ibrahim MM, Nassar A, Daruish M, El-Zimaity M, et al. Suggested Guidelines for the Treatment of Mycosis Fungoides in Countries with Limited Resources. Dermatol Res Pract. 2023;2023:1360740.
  • 9- Gökdemir G, Barutcuoglu B, Sakiz D, Köşlü A. Narrowband UVB phototherapy for early-stage mycosis fungoides: evaluation of clinical and histopathological changes. J Eur Acad Dermatol Venereol. 2006;20(7):804-9.
  • 10- Atci T, Baykal C. Efficacy of narrow-band ultraviolet-B therapy in patch-stage mycosis fungoides: A clinical study and review of the literature. Photodermatol Photoimmunol Photomed. 2020 Jul;36(4):271-277.
  • 11- Mehta D, Lim HW. Ultraviolet B Phototherapy for Psoriasis: Review of Practical Guidelines. Am J Clin Dermatol. 2016;17(2):125-33.
  • 12- Fatima S, Siddiqui S, Tariq MU, Ishtiaque H, Idrees R, Ahmed Z, et al. Mycosis Fungoides: A Clinicopathological Study of 60 Cases from a Tertiary Care Center. Indian J Dermatol. 2020;65(2):123-129.
  • 13- Clark C, Dawe RS, Evans AT, Lowe G, Ferguson J. Narrowband TL-01 Phototherapy for Patch-Stage Mycosis Fungoides. Arch Dermatol. 2000;136(6):748–752.
  • 14- Hofer A, Cerroni L, Kerl H, Wolf P. Narrowband (311-nm) UV-B therapy for small plaque parapsoriasis and early-stage mycosis fungoides. Arch Dermatol. 1999;135(11):1377- 80.
  • 15- Ponte P, Serrao V, Apetato M. Efficacy of narrowband UVB vs. PUVA in patients with early-stage mycosis fungoides. J Eur Acad Dermatol Venereol. 2010;24:716-721.
  • 16- Boztepe G, Sahin S, Ayhan M, Erkin G, Kilemen F. Narrowband ultraviolet B phototherapy to clear and maintain clearance in patients with mycosis fungoides. J Am Acad Dermatol. 2005; 53:242-246.
  • 17- Dereure O, Picot E, Comte C, Bessis D, Guillot B. Treatment of early stages of mycosis fungoides with narrowband ultraviolet B. A clinical, histological and molecular evaluation of results. Dermatology. 2009;218:1-6.
  • 18- Diederen PV, van Weelden H, Sanders CJ, Toonstra J, van Vloten WA. Narrowband UVB and psoralen-UVA in the treatment of early-stage mycosis fungoides: a retrospective study. J Am Acad Dermatol. 2003;48:215-219.
  • 19- Gathers RC, Scherschun L, Malick F, Fivenson DP, Lim HW. Narrowband UVB phototherapy for early-stage mycosis fungoides. J Am Acad Dermatol. 2002;47:191-197.
  • 20- Pavlotsky F, Barzilai A, Kasem R, Shpiro D, Trau H. UVB in the management of early stage mycosis fungoides. J Eur Acad Dermatol Venereol. 2006 May;20(5):565-72.
  • 21- Jang MS, Baek JW, Park JB, Kang DY, Kang JS, Suh KS, et al. Narrowband ultraviolet B phototherapy of early stage mycosis fungoides in korean patients. Ann Dermatol. 2011 Nov;23(4):474-80.
  • 22- Coronel-Pérez IM, Carrizosa-Esquivel AM, Camacho-Martínez F. Tratamiento con UVB de banda estrecha de los estadios iniciales de la micosis fungoide. Estudio de 23 pacientes [Narrow band UVB therapy in early stage mycosis fungoides. A study of 23 patients]. Actas Dermosifiliogr. 2007 May;98(4):259-64.
  • 23- Reyes V, Bosio BM, Ruiz LA, Kurpis M. Treatment of early stages of mycosis fungoides with narrow band UVB the mycosis fungoides in early stage. Med Cutan Iber Lat Am. 2019;47(1):29-33.
  • 24- Elcin G, Duman N, Karahan S, Ersoy-Evans S, Erkin G, Karaduman A, et al. Long-term follow-up of early mycosis fungoides patients treated with narrowband ultraviolet B phototherapy. J Dermatolog Treat. 2014;25:268-273
  • 25- Hodak E, Geskin L, Guenova E, Ortiz-Romero PL, Willemze R, Zheng J, et al. Real-Life Barriers to Diagnosis of Early Mycosis Fungoides: An International Expert Panel Discussion. Am J Clin Dermatol. 2023 Jan;24(1):5-14.
  • 26- Ko MJ, Yang JY, Wu HY, Hu FC, Chen SI, Tsai PJ, et al. Narrowband ultraviolet B phototherapy for patients with refractory uraemic pruritus: a randomized controlled trial. Br J Dermatol. 2011 ;165(3):633-9.
  • 27- Trautinger F, Knobler R, Willemze R, Peris K, Stadler R, Laroche L, et al. EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome. Eur J Cancer. 2006;42:1014-1030.
  • 28- Gara S, Litaiem N, Bacha T, Jmour Y, Zeglaoui F. Maintenance Phototherapy for the Treatment of Early-stage Mycosis Fungoides. J Clin Aesthet Dermatol. 2021;14(10):25- 26.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Dermatoloji
Bölüm Araştırma Makalesi
Yazarlar

Berkay Temel 0000-0001-5528-9006

İpek Kara 0000-0002-2432-8073

Nermin Karaosmanoğlu 0000-0002-3462-1628

Yayımlanma Tarihi 22 Ocak 2025
Gönderilme Tarihi 24 Nisan 2024
Kabul Tarihi 4 Kasım 2024
Yayımlandığı Sayı Yıl 2024

Kaynak Göster

AMA Temel B, Kara İ, Karaosmanoğlu N. Erken evre Mikozis fungoides nedeniyle darband ultraviyole B fototerapisi alan hastaların değerlendirilmesi. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. Ocak 2025;57(3):110-113. doi:10.20492/aeahtd.1472165