Archives of dermatology · 1998
Topical corticosteroids for mycosis fungoides. Experience in 79 patients.
Сравнительное исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Zackheim H S, Kashani-Sabet M, Amin S
Аннотация
OBJECTIVE: To determine the effectiveness of topical corticosteroids in the management of mycosis fungoides.
DESIGN: Prospective study.
SETTING: Academic referral center, Veterans Affairs Medical Center, and private practice.
PATIENTS: Seventy-nine patients with patch or plaque stage of mycosis fungoides. Fifty-one were stage T1 (less than 10% of skin involved) and 28 were stage T2 (10% or more of skin involved). Seventy-five had patch-stage and 4 had plaque-stage disease as determined by histological examination.
INTERVENTION: Patients were treated with topical class I to III corticosteroids. Of the stage T1 patients, all used class I corticosteroids, and 4 (8%) also used class II or III corticosteroids. Of the stage T2 patients, 19 (68%) used class I and 12 (43%) used class II or III compounds. Some patients used more than 1 class of corticosteroid. Applications were almost always twice daily. Three stage T1 and 2 stage T2 patients used plastic film occlusion. Baseline and monthly morning serum cortisol levels were obtained during treatment.
MAIN OUTCOME MEASURES: Response to treatment and side effects.
RESULTS: The median follow-up period was 9 months. Thirty-two (63%) of stage T1 patients achieved complete remission and 16 (31%) achieved partial remission, for a total response rate of 48 (94%). The comparable figures for stage T2 patients were 7 (25%), 16 (57%), and 23 (82%), respectively. Responses were determined by clinical examination. Thirty-nine patients achieved clinical clearing. In 7 of these, posttreatment biopsy specimens were obtained, and all showed histological clearing. Reversible depression of serum cortisol levels occurred in 10 (13%). Minor skin irritation occurred in 2 patients and localized, reversible skin atrophy in 1.
CONCLUSION: Topical corticosteroids, especially class I compounds, are an effective treatment for patch-stage mycosis fungoides.
DESIGN: Prospective study.
SETTING: Academic referral center, Veterans Affairs Medical Center, and private practice.
PATIENTS: Seventy-nine patients with patch or plaque stage of mycosis fungoides. Fifty-one were stage T1 (less than 10% of skin involved) and 28 were stage T2 (10% or more of skin involved). Seventy-five had patch-stage and 4 had plaque-stage disease as determined by histological examination.
INTERVENTION: Patients were treated with topical class I to III corticosteroids. Of the stage T1 patients, all used class I corticosteroids, and 4 (8%) also used class II or III corticosteroids. Of the stage T2 patients, 19 (68%) used class I and 12 (43%) used class II or III compounds. Some patients used more than 1 class of corticosteroid. Applications were almost always twice daily. Three stage T1 and 2 stage T2 patients used plastic film occlusion. Baseline and monthly morning serum cortisol levels were obtained during treatment.
MAIN OUTCOME MEASURES: Response to treatment and side effects.
RESULTS: The median follow-up period was 9 months. Thirty-two (63%) of stage T1 patients achieved complete remission and 16 (31%) achieved partial remission, for a total response rate of 48 (94%). The comparable figures for stage T2 patients were 7 (25%), 16 (57%), and 23 (82%), respectively. Responses were determined by clinical examination. Thirty-nine patients achieved clinical clearing. In 7 of these, posttreatment biopsy specimens were obtained, and all showed histological clearing. Reversible depression of serum cortisol levels occurred in 10 (13%). Minor skin irritation occurred in 2 patients and localized, reversible skin atrophy in 1.
CONCLUSION: Topical corticosteroids, especially class I compounds, are an effective treatment for patch-stage mycosis fungoides.
Предметные рубрики MeSH
Administration, CutaneousAdolescentAdultAgedAged, 80 and overAnti-Inflammatory AgentsAntineoplastic AgentsBetamethasoneBetamethasone ValerateClobetasolDrug Administration ScheduleFemaleFluocinonideFollow-Up StudiesHumansHydrocortisoneMaleMiddle AgedMycosis FungoidesNeoplasm StagingOcclusive DressingsProspective StudiesRemission InductionSkin NeoplasmsTreatment OutcomeTriamcinolone Acetonide