Guidelines for phototherapy of mycosis fungoides and Sezary syndrome: A consensus statement of the United States Cutaneous Lymphoma Consortium.
BACKGROUND Ultraviolet light (UVL) is a long established treatment for mycosis fungoides (MF) and Sezary syndrome (SS) subtypes of cutaneous T cell lymphoma (CTCL) Treatments have traditionally included broadband, narrowband ultraviolet B light (UVB) and psoralen plus ultraviolet A light photochemotherapy (PUVA) but more recently, treatment options have expanded to include UVA1 and excimer laser. UVL is used either as monotherapy or as an adjuvant to systemic therapy, demonstrating efficacy in many cases that equal or surpass systemic medications. Despite its utility and duration of use, the current practice of using UVL guidelines for psoriasis to treat patients with MF/SS is problematic because the goals of prolonging survival and preventing disease progression are unique to CTCL compared to psoriasis. OBJECTIVES We sought to develop separate guidelines for phototherapy for MF/SS for both clinical practice and for clinical trials. METHODS Literature review and cutaneous lymphoma expert consensus group recommendations. RESULTS This paper reviews the published literature for UVB and UVA/PUVA in MF/SS and suggests practical standardized guidelines for their use. LIMITATIONS New standardization of phototherapy. CONCLUSIONS These guidelines should allow the comparison of results with phototherapy in MF/SS across different stages of patients, centers, and in combination with other agents in practice and in clinical trials.
Journal of the American Academy of Dermatology