Risk of Cutaneous Malignancy in Mycosis Fungoides Patients Treated with PUVA: A Retrospective Study

Abstract

Istanbul Universitesi Istanbul Tip Fakultesi, Dermatoloji Anabilim Dali, Istanbul, Turkiye @Telif Hakki 2015 Turk Dermatoloji Dernegi Makale metnine www. turkdermatolojidergisi.com web sayfasindan ulasilabilir. @Copyright 2015 by Turkish Society of Dermatology Available on-line at www.turkdermatolojidergisi.com Melike Umarova Aslan, Istanbul Universitesi Istanbul Tip Fakultesi, Dermatoloji Anabilim Dali, Istanbul, Turkiye E-posta: melikeumarova@hotmail.com Gelis Tarihi/Submitted: 27.08.2014 Kabul Tarihi/Accepted: 02.12.2014 Yazisma Adresi/ Correspondence: Objective: PUVA therapy is mostly used longer than other diseases in mycosis fungoides (MF) patients. We aimed to investigate the chronic side effects of PUVA therapy, including skin cancer to disclose the actual risk in Turkish population. Methods: We screened all MF patients treated with PUVA at the Department of Dermatology and Venereology of Istanbul Medical Faculty and included patients in whom PUVA has first initiated between 1994 and 2006 and administered in one or several courses and who were followed up more than five years with last visit in 2012. Results: Fifty patients with MF had a mean follow-up duration of 10.2±2.8 years. Six patients (12%) had PUVA lentigines. Two of them (4%) developed skin cancer (basal cell carcinoma, Bowen’s disease) during their follow-up. The mean sessions (295.5±7.8 sessions) and total UVA doses (1452 J/cm2) in these patients with skin cancer were higher than those who did not develop skin cancer (128.7±73 sessions and 515±31 J/ cm2, respectively). There was a significant relationship between the PUVA lentigines and development of cutaneous malignancy (p=0.01). Ozgun Arastirma / Original Investigation 12 Turk J Dermatol 2015; 1: 12-7 • DOI: 10.4274/tdd.2413 13 Umarova Aslan ve ark. PUVA Tedavisinde Deri Kanseri Riski. Turk J Dermatol 2015; 1: 12-7 Conclusion: Cutaneous malignancies were detected in 4% of MF patients followed up approximately 10 years. Due to this low risk, we conclude that PUVA therapy is relatively safe in patients with MF in our country. However, UVA should not be applied in high total doses and patients should be followed-up lifelong.