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  • Title: Plaque stage mycosis fungoides treated with bexarotene at low dosage and UVB-NB.
    Author: D'Acunto C, Gurioli C, Neri I.
    Journal: J Dermatolog Treat; 2010 Jan; 21(1):45-8. PubMed ID: 19603308.
    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.
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