Ultraviolet A Combined with Narrow-Band Ultraviolet B is an Effective Treatment Modality for Early Folliculotropic Mycosis Fungoides and Early Mycosis Fungoides Refractory to Narrow-Band Ultraviolet B: A Retrospective Cohort Study

Abstract

Background. Psoralen plus ultraviolet A (PUVA) is the preferred phototherapeutic modality for early-stage folliculotropic mycosis fungoides (FMF), and for early-stage non-FMF refractory to narrow-band ultraviolet B (NBUVB). However, PUVA has a problematic safety profile. Literature on the treatment with the combination of UVA and NBUVB for MF is sparse. Objective. To evaluate the effectiveness of UVA combined with NBUVB for early-stage MF, specifically for FMF and NBUVB-refractory non-FMF, in adult and pediatric patients. Methods. A retrospective analysis was conducted for patients treated with UVA combined with NBUVB at our center, during 1/2008–8/2022. Results. The cohort included 51 patients: 35 adults and 16 pediatric patients. The overall response rate (ORR) of 39 patients with early-FMF (25 adults and 14 children) was 95%, and the complete response (CR) was 62%. No significant differences in ORR/CR rates were noted between adult and pediatric patients. Of 12 patients with non-FMF (10 adults and 2 children), the ORR was 83% and the CR was 50%. In 17 patients (8 FMF and 9 non-FMF), prior NBUVB therapy resulted in partial response/stable disease; yet, UVA + NBUVB led to CR in 9 patients (4 FMF and 5 non-FMF). Side effects were minimal. Conclusion. Combined UVA and NBUVB is a good alternative to PUVA for adult or pediatric patients with early-stage MF , with FMF or non-FMF refractory to NBUVB.