First-line treatment in lymphomatoid papulosis: a retrospective multicentre study

Fernández-de-Misa, Ricardo; Hernández‐Machín, Buenaventura; Servitje, Octavio; Valentí-Medina, F.; Maroñas‐Jiménez, Lidia; Ortiz‐Romero, Pablo L.; Schmidt, Janine; Pujol, Ramón M.; Gallardo, Fernando; Pau-Charles, Ignasi; Muret, Ma Pilar García; Gala, S. Pérez; Román, Concepción; Cañueto, Javier; Rius, L. Blanch; Izu, R.; Ortiz‐Brugués, Ariadna; Martí, Rosa M.; Blanes, Mar; Morillo, Mercedes; Sánchez, P.; Peñate, Yeray; Bastida, Jaume; Gil, Amalia Pérez; López‐Lerma, Ingrid; Muniesa, Cristina; Estrach, Teresa

doi:10.1111/ced.13256

Cited by 35 publications

(34 citation statements)

References 26 publications

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“…Alternatively, PUVA may induce longer lasting photoproducts than UVB does, resulting in a sustained downstream immunosuppressive cascade. Notably, phototherapy with both PUVA or UVB is effective not only in MF but also in lymphomatoid papulosis (LyP) ( 98 ), a disease that sometimes coexists with MF and is characterized by papules and nodules with deep skin infiltration up to 1 cm or more; however, these light treatments only directly reach the infiltrating cells in the most superficial layers but not those in the diseased deep tissue. The immunosuppressive microenvironment induced by phototherapy in the upper layers of the skin may be sufficient to deplete infiltrating cells in LyP and/or prevent the occurrence of new lesions in this intermittent disease.…”

Section: How Does Phototherapy Work?mentioning

confidence: 99%

From Early Immunomodulatory Triggers to Immunosuppressive Outcome: Therapeutic Implications of the Complex Interplay Between the Wavebands of Sunlight and the Skin

Vieyra-Garcia

Wolf

2018

Front. Med.

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Phototherapy is an efficient treatment for many cutaneous diseases that involve the activation of inflammatory pathways or the overgrowth of cells with aberrant phenotype. In this review, we discuss recent advances in photoimmunology, focusing on the effects of UV-based therapies currently used in dermatology. We describe the molecular responses to the main forms of photo(chemo)therapy such as UVB, UVA-1, and PUVA that include the triggering of apoptotic or immunosuppressive pathways and help to clear diseased skin. The early molecular response to UV involves DNA photoproducts, the isomerization of urocanic acid, the secretion of biophospholipids such as platelet activating factor (PAF), the activation of aryl hydrocarbon receptor and inflammasome, and vitamin D synthesis. The simultaneous and complex interaction of these events regulates the activity of the immune system both locally and systemically, resulting in apoptosis of neoplastic and/or benign cells, reduction of cellular infiltrate, and regulation of cytokines and chemokines. Regulatory T-cells and Langerhans cells, among other skin-resident cellular populations, are deeply affected by UV exposure and are therefore important players in the mechanisms of immunomodulation and the therapeutic value of UV in all its forms. We weigh the contribution of these cells to the therapeutic application of UV and how they may participate in transferring the direct impact of UV on the skin into local and systemic immunomodulation. Moreover, we review the therapeutic mechanisms revealed by clinical and laboratory animal investigations in the most common cutaneous diseases treated with phototherapy such as psoriasis, atopic dermatitis, vitiligo, and cutaneous T-cell lymphoma. Better understanding of phototherapeutic mechanisms in these diseases will help advance treatment in general and make future therapeutic strategies more precise, targeted, personalized, safe, and efficient.

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Section: How Does Phototherapy Work?mentioning

confidence: 99%

From Early Immunomodulatory Triggers to Immunosuppressive Outcome: Therapeutic Implications of the Complex Interplay Between the Wavebands of Sunlight and the Skin

Vieyra-Garcia

Wolf

2018

Front. Med.

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“…Complete response rates in these series ranged from 20% to 52%, and partial responses were common. 19,20 When used for LyP, methotrexate is taken orally or administered subcutaneously every 1 to 4 weeks; maintenance is usually required, as recurrences off therapy are common. 19,21 Responses of LyP to methotrexate are often rapid, with resolution within 1 to 2 weekly doses.…”

Section: Skin Directed Systemicmentioning

confidence: 99%

“…19,20 When used for LyP, methotrexate is taken orally or administered subcutaneously every 1 to 4 weeks; maintenance is usually required, as recurrences off therapy are common. 19,21 Responses of LyP to methotrexate are often rapid, with resolution within 1 to 2 weekly doses. We typically start at 10 to 15 mg by mouth weekly, increasing by 2.5 to 5 mg every few weeks until there is complete resolution.…”

Section: Skin Directed Systemicmentioning

confidence: 99%

How I treat primary cutaneous CD30+ lymphoproliferative disorders

Shinohara

Shustov

2019

Blood

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The primary cutaneous CD30+ lymphoproliferative disorders are a family of extranodal lymphoid neoplasms that arise from mature postthymic T cells and localize to the skin. Current classification systems recognize lymphomatoid papulosis (LyP), primary cutaneous anaplastic large cell lymphoma, and borderline cases. In the majority of patients, the prognosis of primary cutaneous CD30+ lymphoproliferative disorders is excellent; however, relapses are common, and complete cures are rare. Skin-directed and systemic therapies are used as monotherapy or in combination to achieve the best disease control and minimize overall toxicity. We discuss 3 distinct presentations of primary cutaneous CD30+ lymphoproliferative disorder and present recommendations for a multidisciplinary team approach to diagnosis, evaluation, and management of these conditions in keeping with existing consensus guidelines.

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“…LyP usually occurs in middle-age patients but can also occur occasionally in elderly patients and children, on the trunk and extremities (21). Eighty percent of LyP cases show generalized skin lesions, with the remaining 20% showing localized skin lesions at presentation (24,33). LyP has a histological appearance of a malignant disease, but exhibits clinically benign behavior (21).…”

Section: Local Radiation For Primary Cutaneous Cd30positive Lymphoproliferative Disordersmentioning

confidence: 99%

Local radiation for cutaneous T-cell lymphoma other than mycosis fungoides and Sézary syndrome

Shikama¹

2019

Chin. Clin. Oncol

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Primary cutaneous lymphoma is the second most common type of extranodal lymphoma. The clinical behavior of this lymphoma differs from that of other extranodal lymphomas and thus requires a particular pretreatment evaluation and treatment strategy. Cutaneous T-cell lymphoma (CTCL) accounts for 80% of primary cutaneous lymphoma cases and includes several confirmed disease entities as well as provisional entities. Local radiation for CTCLs is applicable for both curative and palliative intents and is based on the involved-site radiotherapy (ISRT) concept. Primary cutaneous CD30-positive lymphoproliferative disorders include primary cutaneous anaplastic large-cell lymphoma (C-ALCL), lymphomatoid papulosis (LyP), and borderline lesions, all of which exhibit indolent behavior. One half of all LyP cases show spontaneous regression and do not require active treatment. Solitary or localized C-ALCL cases are treated with surgical excision or local radiation of 24-36 Gy. The most common relapse site after local treatment is other skin areas; however, skin relapse is not associated with worsened prognosis. Subcutaneous panniculitis-like T-cell lymphoma (SPTL) without hemophagocytic syndrome exhibits indolent behavior, and localized lesions can be successfully treated with local radiation of 40 Gy or more. Extranodal NK/T-cell lymphoma, nasal type has an aggressive clinical behavior even with intensive chemotherapy and a dose of 50 Gy or higher might be required for good tumor control. Palliative local radiation of 8 Gy in one or two fractions is effective in treating refractory or relapsed CTCLs. ISRT with curative intent should encompass the original suspicious lesions plus a 2-3 cm margin, while ISRT with palliative intent should encompass visible lesions plus a 1-2 cm margin. Appropriate electron beam energy and bolus thickness should be selected according to the skin surface dose and thickness of the patch and plaque lesions. All CTCL cases should be reviewed by a multidisciplinary team to ensure an appropriate treatment strategy.

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First-line treatment in lymphomatoid papulosis: a retrospective multicentre study

Cited by 35 publications

References 26 publications

From Early Immunomodulatory Triggers to Immunosuppressive Outcome: Therapeutic Implications of the Complex Interplay Between the Wavebands of Sunlight and the Skin

From Early Immunomodulatory Triggers to Immunosuppressive Outcome: Therapeutic Implications of the Complex Interplay Between the Wavebands of Sunlight and the Skin

How I treat primary cutaneous CD30+ lymphoproliferative disorders

Local radiation for cutaneous T-cell lymphoma other than mycosis fungoides and Sézary syndrome

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