32059 The effectiveness of oral alitretinoin on mycosis fungoides palmaris et plantaris

Abstract

Background: Mycosis fungoides palmaris et plantaris (MFPP) is a variant of mycosis fungoides (MF) that presents primarily on the palms and soles, which is often refractory to conventional therapy. Alitretinoin is an endogenous panagonist binding to retinoid receptors and promoting the anti-proliferative, immune-modulating, and pro-apoptotic effects. From this perspective, oral alitretinoin may be effective to MFPP as in the MF, however, there is no previous case study. We present a retrospective review of MFPP treated with oral alitretinoin. Objective: To investigate the efficacy and safety of oral alitretinoin in MFPP. Methods: This study was conducted on 10 patients histopathologically diagnosed as MFPP. The patients were treated with oral alitretinoin (30 mg/day). The therapeutic efficacy was assessed according to Physician’s Global Assessment (PGA) and modified total lesion symptom score (mTLSS) at baseline and after 12 weeks. Results: The proportion of clinical response defined as PGA of clear or almost clear was 70% (7/10). The mean mTLSS was significantly decreased from 10.5 (baseline) to 3.2 (after 12 weeks), representing a 69.5% of reduction. Half of the patients experienced side effects such as headache (20%), elevated serum triglyceride (20%), and dry mouth (10%), however, there were no serious events leading to withdrawal. Conclusion: Oral alitretinoin can be a well-tolerated and effective alternative treatment for MFPP.