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2018, Number 3

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Dermatología Cosmética, Médica y Quirúrgica 2018; 16 (3)

Is puva Maintenance Therapy Necessary in Patients with Early Stage Mycosis Fungoides? Evaluation of a Treatment Guideline, Five Years Follow-up

Colmenares RLM, Zuluaga MA, Jiménez SB, Montoya LP

Language: Spanish
References: 28
Page: 199-205
PDF size: 183.50 Kb.


ABSTRACT

Objective: to evaluate the performance of the MF in patients who stopped completely PUVA therapy after clearance, to generate evidence to guide decision making.
Methods: we follow up a prospective cohort study, a total of 45 patients having MF in early stages were included, for stage IA (n = 22) and IB (n = 23), they were treated with PUVA therapy with 58 sessions minimum, until complete clearance and then were enrolled and followed up every two months for a period five years. The cohort was divided in relapse (13) and non relapse (32) groups and form the outcome was analyzed.
Results: the patients in the relapsed group (n = 13) needed more PUVA sessions to clear skin lesions 138.15 vs. 96.06 sessions in the non relapse group (n = 32) (p = 0.0000). History of initial relapse was the variable with the highest level of evidence associated with future relapses RR: 4.56/CI 95% (1.44 to 14.35) throughout the study (p = 0.0036).
Discussion: Our population showed that suspend PUVA phototherapy did not induce relapse and continue receiving this therapy, did not avoid further relapse of the disease.
Conclusions: this study is a reference for multiple centers worldwide where maintenance therapy despite not recommended in most clinical guides, is still being commonly performed. The five years follow up allowed us to observe the behavior of the disease in this population, which was decreased risks and side effects associated with phototherapy.


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