Potential of narrow-band ultraviolet B to induce sustained durable complete remission off-therapy in patients with stage I mycosis fungoides

Pavlotsky, Felix; Dawood, M. Yusoff; Barzilai, Aviv

doi:10.1016/j.jaad.2018.05.023

Cited by 11 publications

(8 citation statements)

References 26 publications

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“…However, even though relapses were frequent after CR was achieved, in the vast majority of patients, relapses were milder than the initial presentation. This implies that the successful treatment of MF leading to CR, specifically phototherapy, does not only alleviate cutaneous symptoms in the paediatric age group but also perhaps may modify the course of the cutaneous disease (i.e., a disease‐modifying treatment), as suggested for NBUVB in adult MF 29 . Nevertheless, the potential long‐term toxicity of certain modalities, always an important aspect of care in children and adolescents, takes on even more importance in early‐stage paediatric MF because of the chronic and indolent course of the disease.…”

Section: Discussionmentioning

confidence: 99%

“…This implies that the successful treatment of MF leading to CR, specifically phototherapy, does not only alleviate cutaneous symptoms in the paediatric age group but also perhaps may modify the course of the cutaneous disease (i.e., a disease-modifying treatment), as suggested for NBUVB in adult MF. 29 Nevertheless, the potential long-term toxicity of certain modalities, always an important aspect of care in children and adolescents, takes on even more importance in early-stage paediatric MF because of the chronic and indolent course of the disease. In the present study, over a mean followup of more than 9 years, with 63% of the cohort followed into adulthood, only 4/69 patients (6%) experienced any stage progression, and only FMF patients progressed from early to advanced disease.…”

Section: Paediatric Mycosis Fungoidesmentioning

confidence: 99%

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Paediatric mycosis fungoides – characteristics, management and outcomes with particular focus on the folliculotropic variant

Reiter

Amitay‐Laish

Oren‐Shabtai

et al. 2022

Acad Dermatol Venereol

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Background The literature on paediatric mycosis fungoides (MF) and especially its folliculotropic variant (FMF) is sparse. Objectives To describe the clinical manifestations, treatments, outcomes and long‐term course of paediatric MF, including FMF. Methods A retrospective analysis was conducted of all consecutive MF patients diagnosed at ≤18 years attending two medical centres in 1995–2015. Results The cohort included 71 patients, all but two of whom had early‐stage disease: hypopigmented (55%), folliculotropic (42%) and classical MF (39%), alone or in combination. The head and neck area were involved in 43% of patients with early‐stage FMF compared to 12% of the non‐FMF group (P = 0.004). There was no difference in the involvement of other body areas between the groups. Pruritus, although mild, was more often recorded among patients with early‐stage FMF compared to non‐FMF (58% vs. 29%, respectively, P = 0.02). Complete response (CR) was achieved in 60 of the 69 patients with early‐stage MF (87%) after an average of 1.8 treatment modalities. NBUVB was the most administered treatment to non‐FMF patients with CR rates of 63% vs. 29% of FMF patients (P = 0.04). Systemic/bath PUVA and UVA+NBUVB were the most administered treatments to FMF patients with CR rates of 60% vs. 81% for non‐FMF patients (P = 0.17). During a mean follow‐up of 9.2 years (range 1–24), stage progression was observed in four (6%) of the patients with early‐stage disease, two of whom (all FMF) to advanced stage. Conclusions Paediatric MF presents as an early‐stage disease with over‐representation of hypopigmented and FMF variants. NBUVB and UVA‐based therapies yield good response rates in non‐FMF and FMF patients, respectively. Disease course is indolent, and even on relatively long follow‐up, it has a very low progression rate from early to advanced‐stage disease, occurring in patients with FMF. We propose a treatment algorithm for paediatric MF.

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Section: Discussionmentioning

confidence: 99%

Section: Paediatric Mycosis Fungoidesmentioning

confidence: 99%

Paediatric mycosis fungoides – characteristics, management and outcomes with particular focus on the folliculotropic variant

Reiter

Amitay‐Laish

Oren‐Shabtai

et al. 2022

Acad Dermatol Venereol

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“…A cohort study of 117 patients with stage I mycosis fungoides treated with a single course of NB-UVB showed an 80% complete response rate and a 60% disease-free survival of more than five years after treatment. Patients more likely to achieve this outcome were under the age of 50 and had stage IA disease [ 34 ].…”

Section: Reviewmentioning

confidence: 99%

An Update on Narrowband Ultraviolet B Therapy for the Treatment of Skin Diseases

Myers¹,

Kheradmand²,

Miller³

2021

Cureus

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The objective of this review is to provide an update on narrowband ultraviolet B (NB-UVB) as a treatment for various skin conditions. NB-UVB works by suppressing the cutaneous cell-mediated immune response and has been shown to be an efficacious and clinically tolerable treatment for a range of inflammatory dermatoses. A literature search was conducted by advanced searches of PubMed for NB-UVB treatment of dermatologic skin diseases with a focus on reports from 2010 to 2021, including both office-based and home-based phototherapy (HBPT). Data were prioritized based on studies with a high level of evidence using the Oxford Evidence-Based Medicine guidance. We found that NB-UVB continues to serve as an effective form of therapy for several cutaneous conditions, including vitiligo, psoriasis, atopic dermatitis, mycosis fungoides, and other inflammatory dermatoses. The recent introduction of Janus kinase inhibitors in combination with NB-UVB suggests future promise in the treatment of vitiligo. Despite its rise in popularity, a decline was seen in office-based NB-UVB treatment during the coronavirus disease 2019 pandemic. Options are available to deliver NB-UVB at home with comparable efficacy to office-based treatments. In conclusion, for a select group of patients and conditions, NB-UVB continues to serve as an effective treatment modality with minimal side effects, with HBPT serving as an option to improve patient compliance.

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“…To the Editor: We congratulate Pavlotsky and colleagues for their study assessing long-term disease-free survival in stage I mycosis fungoides (MF) treated with narrowband ultraviolet B therapy. 1 We would like to raise some pertinent issues regarding the management of stage IA MF (\10% body surface area and no lymph node involvement).…”

mentioning

confidence: 99%

“…Pavlotsky and colleagues also noted that disease-free survival was significantly reduced in patients older than 50 years and those with disease stage IB. 1 Moreover, the variables that determine the rate of progression of MF seem to extend beyond the clinical staging. Inability to attain an initial complete response, higher age, natural UV exposure, ethnicity, and folliculotropism seem to determine disease progression to variable extents.…”

mentioning

confidence: 99%

Stage IA mycosis fungoides: When not to treat?

Bishnoi

Kumar

Vinay

2020

Journal of the American Academy of Dermatology

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Potential of narrow-band ultraviolet B to induce sustained durable complete remission off-therapy in patients with stage I mycosis fungoides

Cited by 11 publications

References 26 publications

Paediatric mycosis fungoides – characteristics, management and outcomes with particular focus on the folliculotropic variant

Paediatric mycosis fungoides – characteristics, management and outcomes with particular focus on the folliculotropic variant

An Update on Narrowband Ultraviolet B Therapy for the Treatment of Skin Diseases

Stage IA mycosis fungoides: When not to treat?

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