Abstract

A clinical decision report using Vieyra-Garcia P, Fink-Puches R, Porkert S, et al. Evaluation of Low-Dose, Low-Frequency Oral Psoralen–UV-A Treatment With or Without Maintenance on Early-Stage Mycosis Fungoides. JAMA Dermatology. 2019;155(5):538. https://doi.org/10.1001/jamadermatol.2018.5905 for a patient weighing whether to continue treatment in light of socioeconomic circumstances.

Highlights

  • Maria Johnson is a 47-year-old African American female, with no significant past medical history, presented to the dermatology clinic with complaints of pruritic hypopigmented patches on her back, abdomen, and arms for the past year

  • Ms Johnson was started on a treatment of Psoralen–UV-A (PUVA) photochemotherapy twice weekly for 10 weeks, and she began to see a very promising positive response

  • Results were further filtered down by analyzing every title and abstract to discern which papers would be most relevant to the clinical question, One of the relevant articles was a prospective cohort study by Sanchez et al, which compared patients on maintenance therapy with no follow up therapy.[3]

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Summary

Clinical Context

Maria Johnson (pseudonym) is a 47-year-old African American female, with no significant past medical history, presented to the dermatology clinic with complaints of pruritic hypopigmented patches on her back, abdomen, and arms for the past year. This prompted a discussion between Ms Johnson and her physician about the length of treatment for her condition She had expressed some concerns about continuing treatment any longer, because she was worried about the dangers of exposing her skin to additional UV light given her family history of skin cancer. She was having trouble commuting to the office to get the physical treatment several times a week due to her socioeconomic situation; she was without a vehicle and was traveling to her appointments via friends or public transportation. Context, maintenance light therapy was still the recommendation, though there remains some disagreement about the benefits and its use varies from institution to institution

Research Article
Related Literature
Critical Appraisal
Clinical Application
Findings
New Knowledge Related to Clinical Decision Science
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