Plaque stage mycosis fungoides treated with bexarotene at low dosage and UVB-NB

J Dermatolog Treat. 2010 Jan;21(1):45-8. doi: 10.3109/09546630903103980.

Abstract

Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma (CTCL), a non-Hodgkin lymphoma characterized by proliferation of atypical epidermotrophic helper/memory T cells in the skin. Therapeutic management includes topical therapy such as topical corticosteroids, topical chemotherapy or phototherapy; or systemic therapy such as photochemotherapy (psoralen and ultraviolet A [PUVA]), extracorporeal phototherapy, radiation, and mono or polychemotherapy. Herein we report one case of MF unresponsive to conventional therapy, subsequently treated with bexarotene and narrow-band ultraviolet B (UVB-NB). Bexarotene belongs to a new subclass of retinoids, binding primarily the nuclear hormone receptors RXRs. Bexarotene has the same effect as its natural counterpart: 9-cis-retinoic acid. Bexarotene may be used alone or in association with interferon alfa, interferon gamma, extracorporeal photophoresis and PUVA. We utilized 75 mg/day of bexarotene associated with 0.3 J/cm(2) UVB-NB as an initial dose. The sessions were three times weekly and the irradiation was increased by 30% at each session to reach a maximum of 1.6 J/cm(2). After 8 week treatment, clinical lesions markedly improved without recording hypercholesterolemia or hypothyroidism. During the follow-up no relapses were detected. We suggest that the combined therapy UVB-NB and bexarotene may be considered as an alternative treatment to PUVA and bexarotene.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anticarcinogenic Agents / therapeutic use*
  • Bexarotene
  • Female
  • Humans
  • Mycosis Fungoides / pathology
  • Mycosis Fungoides / therapy*
  • PUVA Therapy*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy*
  • Tetrahydronaphthalenes / therapeutic use*

Substances

  • Anticarcinogenic Agents
  • Tetrahydronaphthalenes
  • Bexarotene