Mycosis fungoides treated with a combination of topical psoralen and ultraviolet A, interferon gamma-1a, and low-dose etoposide therapy : A case report

Abstract

A 78-year-old woman was diagnosed with mycosis fungoides (MF) stage IB (T2bN0M0B0). Her disease state had been maintained for 4 years with the use of narrow-band ultraviolet B therapy ; however, she was observed to have developed erythroderma. Topical psoralen and ultraviolet A (PUVA) therapy failed to control her disease adequately, and concomitant administration of interferon (IFN) gamma-1a was initiated with the topical PUVA therapy. Her skin disease improved significantly after 4 weeks of therapy, and the improvement was maintained over 5 months. Erythematous plaques showed a tendency to spread over her body to involve 40% of her body surface area (BSA) after 27 weeks of the combination therapy. She was thereafter managed with 3 cycles of low-dose etoposide, following which the areas of erythematous plaques were reduced and involved only 2% of her BSA. Combination therapy using topical PUVA, IFN gamma-1a, and low-dose etoposide was effective to treat erythrodermic stage MF. The present case suggests that combination therapy might be a useful treatment option for advanced-stage MF.[Skin Cancer (Japan) 2017 ; 32 : 256-260]