Treatment Plan

(1)

Department of Health Management, New York Medical College, Valhalla, New York, USA

(2)

University of British Columbia, Vancouver, British Columbia, Canada

(3)

Misdiagnosis Association, Seattle, Washington, USA

Keywords

Psoralen and ultraviolet A (PUVA)InterferonIFNMycosis fungoidesTreatment plan

The main purpose of the study presented herein (previously unpublished) was to determine and compare the efficacy of two treatment methods—one being psoralen and ultraviolet A (PUVA) monotherapy and the other being PUVA combined with interferon-alpha-2a—in mycosis fungoides (MF) patients referred to the Razi Dermatology Hospital in Tehran, Iran. Our efforts focused on the comparison of these two treatment regimens with respect to complete remission, partial remission, different phases of MF, and effect of gender.

PUVA Monotherapy

Patients were given 8-methoxypsoralen 0.6 mg kg⁻¹ PO 2 h prior to UVA exposure. Patients were treated with PUVA three times weekly. Whole body UVA was given in a Dixwell R cabin, which contained 38 UVA fluorescent tubes. Patients wore UVA protective goggles for 24 h after treatment and men wore genital protection. The initial dose was calculated based on Fitzpatrick’s skin type (skin type I = 1.5 J cm⁻², type II = 2.5 J cm⁻², type III = 3.5 J cm⁻²). The weekly incremental increase was given according to skin type (I = 0.5 J cm⁻², type II = 0.5 J cm⁻², type III = 1.0 J cm⁻²). Treatment was based on minimum phototoxic dose (MPD) testing and a 20 % incremental increase was given after each visit, twice weekly. The first eight test doses (0.5, 0.7, 1.0, 1.4, 2.0, 2.8, 3.9, and 5.5 J cm⁻²) were used for patients with skin types I and II. Patients with skin type III received six doses of 2.0, 2.8, 3.9, 5.5, 7.7, and 10.8 J cm⁻².

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