ORIGINAL ARTICLE   

Giornale Italiano di Dermatologia e Venereologia 2020 June;155(3):306-11

DOI: 10.23736/S0392-0488.18.05867-4

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Clinical and histological evaluation in patients with mycosis fungoides treated with UVA1

Emanuele TROVATO ¹ ✉, Michele PELLEGRINO ¹, Federica FILIPPI ², Virginia MANCINI ³, Nicola PIMPINELLI ⁴, Michele FIMIANI ¹

¹ Unit of Dermatology, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy; ² Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; ³ Unit of Pathological Anatomy, Department of Human Pathology and Oncology, University of Siena, Siena, Italy; ⁴ Unit of Dermatology and Venereology, Department of Surgery and Translational Medicine, Medical School, University of Florence, Florence, Italy

BACKGROUND: UVA1 phototherapy is a valid therapeutic alternative for skin lymphoproliferative disorders, although there are few studies concerning its role in mycosis fungoides (MF). Our aim was to evaluate and confirm the effectiveness of UVA1 phototherapy in patients in early stage MF.
METHODS: We enrolled 12 patients, 9 males and 3 females (mean age 54.83±9.99, range 36-74) with a histological diagnosis of mycosis fungoides at early stage. All patients were treated with UVA1 for 22 sessions with two different protocols (3 times or 5 times per week) at the dose of 45 J/cm2. A punch biopsy was performed before and after the treatment, to evaluate the variation of histological features and of the proliferation index (Ki67/MIB1).
RESULTS: At the end of the study, we found a marked clinical improvement in all patients, associated to a statistically significant reduction of the proliferation index Ki67/MIB1. Five patients achieved a complete clinical and histological response, while six a partial one and only one a minimal response.
CONCLUSIONS: Although in recent years the number of the therapeutic options available for all types of skin lymphoproliferative disorders, in particular mycosis fungoides, has increased considerably, there are few studies concerning UVA1 phototherapy. Our results represent a starting point for further studies, in order to investigate the role that these UV-rays can play either alone or in combination with other therapeutic regimens.

KEY WORDS: Phototherapy; Mycosis fungoides; Histological techniques