Mycosis fungoides: epidemiologic study of 17 cases and evaluation of PUVA photochemotherapy Micose fungóide: estudo epidemiológico de 17 casos e avaliação da resposta terapêutica à PUVA

BACKGROUND PUVA photochemotherapy is indicated to treat mycosis fungoides, either as monotherapy in the earlier stages of the disease or in combination with other drugs in more advanced stages of evolution. OBJECTIVES – To evaluate PUVA photochemotherapy response in patients with mycosis fungoides. METHODS From January 1996 to November 2003, 17 patients with a diagnosis of mycosis fungoides were seen in the Dermatological Phototherapy Division of Santa Casa de Sao Paulo, Brazil. PUVA treatment was carried out as monotherapy at early stages of evolution and in combination with other treatments in more advanced cases of mycosis fungoides. The treatment response was evaluated regarding cutaneous clinical and histological improvement. RESULTS Fourteen of 16 patients improved after PUVA. The rate of improvement in skin after treatment related to the initial stage of disease presented as follows: five patients (one in stage IA and four in IB) had total control (cure of lesions); four (all IB) had major regression (improvement of 70%-99%); two (IIB and IVA) had moderated improvement (50%-69%); three (IA, IB, IIA) had mild regression (less than 50%); two (IB, IIB) were unaltered. Only one patient had to discontinue treatment due to intense burning. CONCLUSION – Eighty-seven percent patients responded to PUVA therapy, and 56% presented total control or significant improvement of lesions. The effectiveness of treatment resulted in regression of lesions mainly in early stage cases. PUVA photochemotherapy was a successful and safe treatment, making it a good choice for patients with mycosis fungoides.