Clinical characterization of mycosis fungoides with abnormal light reactions induced by narrow-band UVB therapy: A review of a single-center experience.

Megumi Mizawa, Teruhiko Makino, Fumina Furukawa, Tadamichi Shimizu
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Abstract

Narrow-band UVB (NB-UVB) therapy at a wavelength of 311 nm is often used to treat mycosis fungoides (MF). However, we occasionally encounter cases of erythema induced by low doses of NB-UVB, known as an abnormal light reaction (ALR). We investigated the incidence of ALR in patients with MF and the association between ALR and clinical and laboratory findings. Forty patients (30 men and 10 women) with MF (excluding patients treated with bexarotene or etretinate) who received NB-UVB therapy at the Department of Dermatology, University of Toyama, from January to December 2022 were analyzed. ALR was defined as erythema caused by NB-UVB irradiation of the nonlesional skin at a dose of ≤0.5 J/cm2. ALR occurred in six of 40 patients (15%). The main symptoms of ALR are erythema, irritation, and itching. ALR was observed in patients with Fitzpatrick skin types II and III, and was more common in patients with T2 and T4 disease than in others. The mechanism underlying its occurrence is unknown; however, it has been suggested that ALR is more likely to occur in patients with extensive skin lesions. In addition, treatment can be continued by reducing the dose of NB-UVB or switching to a 308-nm excimer laser, even when ALR occurs. Accumulation of additional cases is required because there were only six patients with ALR in this study.

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窄带UVB治疗引起的蕈样真菌病伴异常光反应的临床特征:单中心经验回顾。
波长为311 nm的窄带中波紫外线(NB-UVB)治疗常用于治疗蕈样真菌病(MF)。然而,我们偶尔会遇到由低剂量NB-UVB引起的红斑病例,称为异常光反应(ALR)。我们调查了MF患者ALR的发生率以及ALR与临床和实验室结果之间的关系。对2022年1月至12月富山大学皮肤科接受NB-UVB治疗的40例MF患者(30男10女)(不包括接受贝沙罗汀或依替酸酯治疗的患者)进行分析。ALR定义为NB-UVB在≤0.5 J/cm2剂量下照射非病变皮肤引起的红斑。40例患者中有6例发生ALR(15%)。ALR的主要症状是红斑、刺激和瘙痒。II型和III型Fitzpatrick皮肤患者均出现ALR, T2和T4型患者较其他患者多见。其发生的机制尚不清楚;然而,有研究表明,ALR更可能发生在有广泛皮肤病变的患者身上。此外,即使发生ALR,也可以通过减少NB-UVB剂量或切换到308 nm准分子激光来继续治疗。由于本研究中只有6例ALR患者,因此需要积累额外的病例。
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