Successful use of the 308-nm excimer laser in early patch stage mycosis fungoides.
Journal of Lasers in Medical Sciences,
Vol. 10 No. 3 (2019),
6 July 2019
,
Page 251-253
Abstract
Introduction: Mycosis fungoides (MF), a type of cutaneous T-cell lymphoma, is a rare condition with a variety of treatment options. A frequently utilized method in the treatment of early-stage MF is phototherapy. Full body phototherapy can be associated with photoaging of the skin and an increased risk of developing skin cancer. Targeted phototherapy, with a 308-nm excimer laser, may be just as effective and of a lower risk. This makes it especially useful in the treatment of patients with dysplastic nevi (DN) or other conditions which can put them at a higher risk of developing skin cancer. There are currently limited data on the treatment of early-stage MF with an excimer laser.
Case Report: This study reports on a 43-year-old female patient presented to the clinic with early-stage (Ia) MF. Given her history of DN, she wished to pursue targeted phototherapy with an excimer laser. Localized light treatment was performed via a 308-nm excimer laser, 3 times weekly, for a total of 17 treatments to affected lesions. Following excimer laser treatment, she had a clinical resolution of her patches. On the follow-up clinic visits, she maintained her excellent response 12 months out.
Conclusion: Targeted phototherapy with a 308-nm excimer laser may be a safer and equally effective alternative to generalized phototherapy in the treatment of early-stage MF. This case report demonstrates its efficacy and advantages over traditional generalized phototherapy.
- Excimer
- Lasers
- Mycosis fungoides
How to Cite
References
Criscione VD, Weinstock MA. Incidence of cutaneous T-cell lymphoma in the United States, 1973-2002. Arch Dermatol. 2007;143(7):854-859. doi:10.1001/archderm.143.7.854.
Sant M, Allemani C, Tereanu C, et al. Incidence of hematologic malignancies in Europe by morphologic subtype: results of the HAEMACARE project. Blood. 2010;116(19):3724-3734. doi:10.1182/blood-2010-05-282632.
Korgavkar K, Xiong M, Weinstock M. Changing incidence trends of cutaneous T-cell lymphoma. JAMA Dermatol. 2013;149(11):1295-1299. doi:10.1001/jamadermatol.2013.5526.
Bradford PT, Devesa SS, Anderson WF, Toro JR. Cutaneous lymphoma incidence patterns in the United States: a population based study of 3884 cases. Blood. 2009;113(21):5064-5073. doi:10.1182/blood-2008-10-184168.
Fujita A, Hamada T, Iwatsuki K. Retrospective analysis of 133 patients with cutaneous lymphomas from a single Japanese medical center between 1995 and 2008. J Dermatol. 2011;38(6):524-530. doi:10.1111/j.1346-8138.2010.01049.x.
Demierre MF, Gan S, Jones J, Miller DR. Significant impact of cutaneous T-cell lymphoma on patients’ quality of life: results of 2005 National Cutaneous Lymphoma Foundation Survey. Cancer. 2006;107(10):2504-2511. doi:10.1002/cncr.22252.
Pimpinelli N, Olsen EA, Santucci M, et al. Defining early mycosis fungoides. J Am Acad Dermatol. 2005;53(6):1053- 1063. doi:10.1016/j.jaad.2005.08.057.
Fung MA, Murphy MJ, Hoss DM, Grant-Kels JM. Practical evaluation and management of cutaneous lymphoma. J Am Acad Dermatol. 2002;46(3):325-357.
Shipman AR, Scarisbrick J. New Treatment Options for Mycosis Fungoides. Indian J Dermatol. 2016;61(1):119. doi:10.4103/0019-5154.174085.
Ramsay DL, Meller JA, Zackheim HS. Topical treatment of early cutaneous T-cell lymphoma. Hematol Oncol Clin North Am. 1995;9(5):1031-1056.
Heald P, Mehlmauer M, Martin AG, Crowley CA, Yocum RC, Reich SD. Topical bexarotene therapy for patients with refractory or persistent early-stage cutaneous T-cell lymphoma: results of the phase III clinical trial. J Am Acad Dermatol. 2003;49(5):801-815. doi:10.1067/s0190.
Stern RS, Nichols KT, Vakeva LH. Malignant melanoma in patients treated for psoriasis with methoxsalen (psoralen) and ultraviolet A radiation (PUVA). The PUVA Follow-Up Study. N Engl J Med. 1997;336(15):1041-1045. doi:10.1056/ nejm199704103361501.
Stern RS. The risk of squamous cell and basal cell cancer associated with psoralen and ultraviolet A therapy: a 30-year prospective study. J Am Acad Dermatol. 2012;66(4):553- 562. doi:10.1016/j.jaad.2011.04.004.
Hamzavi I, Lui H. Using light in dermatology: an updateon lasers, ultraviolet phototherapy, and photodynamic therapy. Dermatol Clin. 2005;23(2):199-207. doi:10.1016/j. det.2004.11.001.
Deaver D, Cauthen A, Cohen G, Sokol L, Glass F. Excimer laser in the treatment of mycosis fungoides. J Am Acad Dermatol. 2014;70(6):1058-1060. doi:10.1016/j. jaad.2014.01.915
Jin SP, Jeon YK, Cho KH, Chung JH. Excimer laser therapy (308 nm) for mycosis fungoides palmaris et plantaris: a skin-directed and anatomically feasible treatment. Br J Dermatol. 2010;163(3):651-653. doi:10.1111/j.1365- 2133.2010.09793.x
Nistico SP, Saraceno R, Schipani C, Costanzo A, Chimenti S. Different applications of monochromatic excimer light in skin diseases. Photomed Laser Surg. 2009;27(4):647-654. doi:10.1089/pho.2008.2317
Abel EA, Sendagorta E, Hoppe RT. Cutaneous malignancies and metastatic squamous cell carcinoma following topical therapies for mycosis fungoides. J Am Acad Dermatol. 1986;14(6):1029-1038.
Lapolla W, Yentzer BA, Bagel J, Halvorson CR, Feldman SR. A review of phototherapy protocols for psoriasis treatment. J Am Acad Dermatol. 2011;64(5):936-949. doi:10.1016/j. jaad.2009.12.054
Fikrle T, Pizinger K. The use of the 308 nm excimer laser for the treatment of psoriasis. J Dtsch Dermatol Ges. 2003;1(7):559-563.
Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 5. Guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy. J Am Acad Dermatol. 2010;62(1):114-135. doi:10.1016/j. jaad.2009.08.026.
Buckland M, Smith JS, Hill D, Feldman SR. A Review of Localized Office and Home Devices in the Treatment of Psoriasis. J Psoriasis Psoriatic Arthritis. 2016;2(1):22-30. doi:10.1177/247553031600200104.
Mudigonda T, Dabade TS, Feldman SR. A review of protocols for 308 nm excimer laser phototherapy in psoriasis. J Drugs Dermatol. 2012;11(1):92-97.
- Abstract Viewed: 376 times
- PDF Downloaded: 199 times