Narrowband ultraviolet B and psoralen plus ultraviolet A phototherapy treatment for mycosis fungoides: a 17-year retrospective cohort study in a university teaching hospital, 2007-24.

BACKGROUND

Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma. MF is typically managed with narrowband ultraviolet B (NB-UVB) or psoralen plus ultraviolet A (PUVA) phototherapy. However, comparative data on their efficacy remain limited.

OBJECTIVES

To evaluate the treatment outcomes of NB-UVB and PUVA in MF and to identify clinical and demographic predictors of response.

METHODS

This was a retrospective cohort study of 33 patients with biopsy-proven MF treated with NB-UVB or PUVA between 2007 and 2024 in the dermatology department at the Sandwell and West Birmingham Hospitals National Health Service Trust. Statistical analysis was performed using Microsoft Excel version 2023 and R version 2023.03.1 + 446.

RESULTS

Of the 33 patients (median age 58 years), 26 (79%) received NB-UVB, 5 (15%) PUVA and 2 (6%) both. Complete remission was achieved in 15 cases (45%) and partial remission in 15 (45%), with 3 (9%) showing no response. Patients with hypopigmented MF had significantly better outcomes than those with hyperpigmented MF (P = 0.02). Advanced stage at treatment initiation was associated with poorer outcomes (P = 0.009). No significant difference was observed in response by sex, age or type of phototherapy. Phototherapy was well tolerated, with adverse effects in only three patients (9%).

CONCLUSIONS

NB-UVB and PUVA are effective and well tolerated for the treatment of MF. Hypopigmented variants and -early-disease stage predicted better outcomes.