Is photochemotherapy an effective treatment of mycosis fungoides?

Yes. The response rates to psoralen plus ultraviolet A (PUVA) are at least equal to those with topical nitrogen mustard. Ultraviolet light irradiation required special instruments for whole skin irradiation of UVA light. Adding psoralens potentiates the effects of UVA light (PUVA). A study from Sweden, where PUVA is the treatment of choice, showed a 50% decrease in mortality from mycosis fungoides after the introduction of PUVA. UVB therapy may work in some patients with early patches and plaques. Newer NBUVB (311- to 313-nm range) phototherapy has certain advantages over PUVA: no oral premedication required, eliminating systemic side effects, and long-term skin carcinogenic effects may be decreased. Small studies of PUVA and oral and topical bexarotene (Targretin) indicate a combination treatment of light and retinoids may have synergistic benefit.

Swanbeck G, Roupe G, Sandstrom MH: Indications of a considerable decrease in the death rate in mycosis fungoides by PUVA treatment, Acta Derm Venereol (Stockh) 74:465–466, 1994.