"High-dose" UVA1 therapy of widespread plaque-type, nodular, and erythrodermic mycosis fungoides

Background: UVA1 (340 to 400 nm) was found to be effective in the treatment of early-stage mycosis fungoides (MF). Objective: The purpose of this study was to assess the efficacy of UVA1 pho totherapy for widespread plaque-type, nodular, and erythrodermic MF. Methods: Thirteen patients (8 with stage IB, 4 with IIB, and 1 with III MF) received 100 J/cm(2) UVA1 daily until remission. Four patients also had le sions inaccessible by UVA1 that were considered control lesions. Immunocyto logic studies of skin infiltrates and circulating T cells were done before and after the therapy. Results: Eleven patients showed complete clinical and histologic responses. Two patients had a partial improvement. Unirradiated control lesions never improved. Serious short-term side effects were not recorded. Circulating C D4(+)/CD45RO(+) and CD4(+)/CD95(+) lymphocytes were significantly reduced b y the therapy. Conclusion: UVA1 therapy is an effective and well-tolerated treatment for a dvanced MF. The therapeutic relevance of the effects on circulating lymphoc ytes remains to be established because lesions in nonexposed cutaneous area s did not respond.