Unilesional plantar mycosis fungoides treated with topical photodynamic therapy – case report and review of the literature

Abstract

PDT is a safe, efficient and non-invasive therapeutical approach for the treatment of UMF and PR. It has no long-standing adverse events and therefore is of high therapeutic value especially in cases of UMF and PR located at special sites like the palms and soles. We propose to include topical PDT as therapeutic option for the treatment of UMF and PR in future guidelines on the management MF.

Successful treatment of palmoplantar dyshidrotic lesions of mycosis fungoides with conventional and daylight photodynamic therapy

“…MF lesions located on the palms and soles are usually difficult to treat, showing lower overall response rates to different treatments [5,6,8]. There is only one published case of MF on the palms treated with cPDT [8], and three cases on the soles [5,6]. In our case, cPDT achieved complete response on the palms and partial response on the soles, where adverse effects (especially the pain) limited therapy.…”

“…Dear Editors, Mycosis fungoides (MF) is the most common subtype of cutaneous T-cell lymphoma. Although early stages of MF generally respond to skin-directed therapies [1], management may be challenging, particularly in some locations [2][3][4][5][6][7][8]. Photodynamic therapy (PDT), approved for the treatment of actinic keratoses, Bowen's disease and superficial basal cell carcinomas [9], is also used off label to treat other conditions, including MF [10].…”

“…Conventional photodynamic therapy has been used in unilesional and paucilesional patch or plaque stage MF, especially in localized lesions resistant to first-line treatments or located in difficult or sensitive areas, such as the face, neck, scalp, axillary and inguinal folds, breast, palms, soles or buttocks [2][3][4][5][6][7][8]. Although low-dose radiotherapy could have been an option as it has shown high efficacy with low toxicity in MF [1,11], we selected PDT to avoid completely the possibility of dysfunctional scarring and paresthesias secondary to radiation.…”

“…The number and frequency of sessions vary among reports, though most agree that more than one session is needed. The most common schedule comprises six sessions at two-week or four-week intervals, using either 5-aminolevulinic acid or MAL [3][4][5][6][7]10]. Recently, Xue et al have summarized the published data on PDT for paucilesional and unilesional MF, informing of a total of 117 MF lesions treated with PDT in 81 patients [3].…”

“…MF lesions located on the palms and soles are usually difficult to treat, showing lower overall response rates to different treatments [5,6,8]. There is only one published case of MF on the palms treated with cPDT [8], and three cases on the soles [5,6].…”