scholarly journals PUVA AND INTERFERON Α COMBINED THERAPY IN PATIENTS WITH MYCOSIS FUNGOIDES

2017 ◽  
Vol 20 (3) ◽  
pp. 132-139
Author(s):  
O. Yu Olisova ◽  
K. V Smirnov ◽  
Ekaterina Vladimirovna Grekova
Keyword(s):  
Total Dose ◽  
Mycosis Fungoides ◽  
Combined Therapy ◽  
Skin Lesions ◽  
Response To Treatment ◽  
Interferon Α ◽  
Puva Therapy ◽  
Cutaneous Manifestations ◽  
Stage Ib ◽  
Stage Ivb

The results of mycosis fungoides (MF) treatment using therapy that combines interferon α (IFNα) and PUVA-therapy are presented. We observed 16 patients with MF. The diagnoses were verified with histological, immunohictochemical methods and molecular analysis. The response to treatment was defined by the index of the modified assessment of the severity of skin lesions scale (mSWAT). In addition, the safety and tolerability of IFNα and PUVA-therapy were evaluated. In terms of the stage of the disease, patients were distributed as follows: IB-IB - 1 (6%), IIA - 3 (19%), IIB - 6 (38%), IIIA - 2 (12.5%), IIIB - 1 (6%), IVA - 2 (12.5%), IVB - 1 (6%). PUVA-therapy was performed four times a week with the initial dose of the irradiation 0.5-1.0 J/cm2. The course of therapy consisted of 40 ± 8 procedures. The total dose was 157 ± 45 J/cm2.IFNα was prescribed to patients (3 IU three times a week). The total dose was 96 ± 31 IU. After the therapy 12 (75%) patients with stage IB-IIIA, mSWAT index was reduced by 90-100%, which corresponded to complete clinical remission in the form of the disappearance of cutaneous manifestations and subjective sensations. 3 (19%) patients with stage IIIB-IVA had mSWAT index decreasing from 50 to 75%, i.e. partial remission was observed as decrease of the injury area and rash brightness, reduce scaling, itching. 1 (6%) patient with stage IVB had no effect of the therapy. Studies have shown that PUVA-therapy in combination with interferon α can be successfully used at patients with MF, regardless of the disease stages, however, more positive effect was in patients with stage IB-IIB MF.

scholarly journals Efficiency of phototherapy in patients with mycosis fungoides: preliminary results of a comparative non-randomized study

2020 ◽  
Vol 96 (5) ◽  
pp. 24-30
Author(s):  
A. E. Karamova ◽  
M. B. Zhilova ◽  
L. F. Znamenskaya ◽  
A. A. Vorontsova
Keyword(s):  
Mycosis Fungoides ◽  
Assessment Tool ◽  
Research Evaluation ◽  
Therapy Group ◽  
Randomized Study ◽  
Skin Lesions ◽  
Puva Therapy ◽  
Level Of Evidence ◽  
European Organization ◽  
Significant Difference

Clinical reasoning. There is a need to optimize the use of UV-B-311 nm and PUVA-therapy in patients with mycosis fungoides to determine the duration of the treatment regimen, the number of sessions per week, and ultraviolet irradiation regimen. Goal of research. Evaluation of the effect of the type and duration phototherapy on efficacy in patients with mycosis fungoides. Principle. A comparative, non-randomized study of the effectiveness of phototherapy in patients with mycosis fungoides in the early stages. Evaluation of the effectiveness of UV-B-311 nm and PUVA therapy was performed using the BSA index (area of skin lesions) and Modified Severity-Weighted Assessment Tool (mSWAT), as well as according to the criteria proposed by the International Society for Skin Lymphomas (ISCL), the European Organization for the Study and Cancer Treatment (EORTC) and United States Cutaneous Lymphoma Consortium (USCLC). Results. The study included 14 patients with mycosis fungoides, 5 of whom received treatment with UV-B-311 nm, 9 PUVA therapy. A strong correlation was found between the duration of UV-B-311 nm therapy with mSWAT delta (R = 0.90; p = 0.038) and BSA delta (R = 0.90; p = 0.038), while similar correlation was not found in the PUVA-therapy group (mSWAT (R = 0.24; p = 0.527); BSA (R = 0.09; p = 0.823)). When comparing the effectiveness of therapy between the treatment group UV-B-311 nm and PUVA therapy, delta mSWAT and BSA at the 20th procedure, delta mSWAT and BSA after the end of therapy did not have a statistically significant difference between the UVB-311 nm and PUVA groups. Conclusion. Statistically significant correlation was found between the number of procedures and the effectiveness of therapy In the UV-B-311 nm group. An increase in the number of PUVA therapy procedures (after 20) does not lead to a statistically significant increase in the effectiveness of treatment. Additional research is needed to increase the level of evidence of the results and develop optimal phototherapy regimens.

scholarly journals Efficiency of phototherapy in patients with mycosis fungoides: preliminary results of a comparative non-randomized study

2020 ◽  
Vol 96 (5) ◽  
pp. 24-30
Author(s):  
A. E. Karamova ◽  
M. B. Zhilova ◽  
L. F. Znamenskaya ◽  
A. A. Vorontsova
Keyword(s):  
Mycosis Fungoides ◽  
Assessment Tool ◽  
Research Evaluation ◽  
Therapy Group ◽  
Randomized Study ◽  
Skin Lesions ◽  
Puva Therapy ◽  
Level Of Evidence ◽  
European Organization ◽  
Significant Difference

Clinical reasoning. There is a need to optimize the use of UV-B-311 nm and PUVA-therapy in patients with mycosis fungoides to determine the duration of the treatment regimen, the number of sessions per week, and ultraviolet irradiation regimen. Goal of research. Evaluation of the effect of the type and duration phototherapy on efficacy in patients with mycosis fungoides. Principle. A comparative, non-randomized study of the effectiveness of phototherapy in patients with mycosis fungoides in the early stages. Evaluation of the effectiveness of UV-B-311 nm and PUVA therapy was performed using the BSA index (area of skin lesions) and Modified Severity-Weighted Assessment Tool (mSWAT), as well as according to the criteria proposed by the International Society for Skin Lymphomas (ISCL), the European Organization for the Study and Cancer Treatment (EORTC) and United States Cutaneous Lymphoma Consortium (USCLC). Results. The study included 14 patients with mycosis fungoides, 5 of whom received treatment with UV-B-311 nm, 9 PUVA therapy. A strong correlation was found between the duration of UV-B-311 nm therapy with mSWAT delta (R = 0.90; p = 0.038) and BSA delta (R = 0.90; p = 0.038), while similar correlation was not found in the PUVA-therapy group (mSWAT (R = 0.24; p = 0.527); BSA (R = 0.09; p = 0.823)). When comparing the effectiveness of therapy between the treatment group UV-B-311 nm and PUVA therapy, delta mSWAT and BSA at the 20th procedure, delta mSWAT and BSA after the end of therapy did not have a statistically significant difference between the UVB-311 nm and PUVA groups. Conclusion. Statistically significant correlation was found between the number of procedures and the effectiveness of therapy In the UV-B-311 nm group. An increase in the number of PUVA therapy procedures (after 20) does not lead to a statistically significant increase in the effectiveness of treatment. Additional research is needed to increase the level of evidence of the results and develop optimal phototherapy regimens.

scholarly journals Cutaneous manifestations of COVID-19 in Mexican patients: A case series and review of literature

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199719
Author(s):  
Juan Carlos Palomo-Pérez ◽  
Maria Elisa Vega-Memije ◽  
David Aguilar-Blancas ◽  
Erik González-Martínez ◽  
Lucia Rangel-Gamboa
Keyword(s):  
Respiratory Symptoms ◽  
Case Series ◽  
Signs And Symptoms ◽  
Skin Lesions ◽  
World Health ◽  
Medical Community ◽  
Atypical Pneumonia ◽  
Cutaneous Lesions ◽  
Cutaneous Manifestations ◽  
Mexican Patients

China officially recognized atypical pneumonia outbreak in December 2019; on 11 March 2020, the World Health Organization declared COVID-19 as a pandemic that is produced by a new coronavirus, named SARS-CoV-2, of rapid transmissibility, which can be asymptomatic, with mild to severe respiratory symptoms, and with cardiovascular, neurological, gastrointestinal, and cutaneous complications. Considering that the pandemic prolonged more than initially expected was prognostic, it is essential for the medical community to identify the signs and symptoms of COVID-19. Thus, this work’s objectives were to present cases of cutaneous lesions observed in COVID-19 Mexican patients. We register cutaneous lesions in COVID-19 patients referred from internal medicine and otorhinolaryngology services to dermatology. We presented four interesting cases with cutaneous lesions, including exanthema morbilliform, urticaria, chilblains, ecchymosis, and facial edema, and review the available literature. The most frequent cutaneous markers are rash, chilblains, and urticaria. Skin lesions may be the first manifestation of COVID-19, accompany initial respiratory symptoms, or appear during the disease course. Symptoms associated with vascular changes (livedo reticularis and vasculitis) are considered of poor prognosis.

Combination of Local PUVA-Therapy and Interferon Alpha-2A in the Treatment of Tumoral Stage Mycosis Fungoides

Dermatology ◽  
1996 ◽  
Vol 193 (1) ◽  
pp. 74-75
Author(s):  
N. Delpuget-Berlin ◽  
P. Bernard ◽  
C. Bedane ◽  
P.-M. Dang ◽  
J.-M. Bonnetblanc
Keyword(s):  
Mycosis Fungoides ◽  
Interferon Alpha ◽  
Puva Therapy

scholarly journals AB0637 EFFICACY OF COMEDICATION OF CONVENTIONAL SYNTHETIC DMARDS WITH TNF BLOCKERS IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1613.3-1614
Author(s):  
K. Ben Abdelghani ◽  
Y. Gzam ◽  
A. Fazaa ◽  
S. Miladi ◽  
K. Ouenniche ◽  
...  
Keyword(s):  
Partial Remission ◽  
Axial Spondyloarthritis ◽  
Combined Therapy ◽  
Response To Treatment ◽  
Tnf Alpha ◽  
Disease Modifying Antirheumatic Drugs ◽  
Significant Difference ◽  
Synthetic Dmards ◽  
The Mean ◽  
Necrosis Factor

Background:Tumour necrosis factor blockers (anti-TNFs) are typically used in axial spondyloarthritis (ax-SpA) when the disease has not responded adequately to conventional therapy. However, the effects of the comedication conventional synthetic disease modifying antirheumatic drugs (csDMARDs) with anti-TNFs are inconclusive.Objectives:The aim of this study was to evaluate the efficacy of comedication csDMARD and anti-TNF compared with anti-TNFs on monotherapy.Methods:A descriptive retrospective study including 85 patients with ax-SpA according to the criteria of the group ASAS on 2009 and having received anti-TNFs between January 2000 and October 2019.The patients were divided on two groups, those who had received combined therapy with cs-DMARDs and those who had received anti-TNFs on monotherapy.The response to treatment was assessed with the ASAS 40 response and partial remission at 3 and 6 months of treatment and was compared between the two groups.Results:Our populations consists of 67 men and 18 women with a mean age of 44,4 ± 10,9 years. The mean period of evolution was 12,3 ± 9,1 years and 52,2% of patients were HLA-B27 positive. The ax-SpA was associated with peripheral arthritis, enthesitis and dactylitis in 17,6%, 17,6% and 1,2% respectively.Fifty-nine patients (69,4%) were treated with anti-TNF alpha on monotherapy and 26 patients (30,6%) had combined therapy. The ASAS 40 response was achieved in 45,6% of patients at 3 months and 64,1 % of them at 6 months of anti-TNFs treatment. Among them, 7,4% had obtained partial remission at 3 months and 20,3% at 6 months of treatment.There was statically significant difference between the two groups on the ASAS 40 response or the partial remission at 3 and 6 months of treatments.Conclusion:The comedication therapy with csDMARDs does not influence the efficacy of anti-TNFs in ax-SpA patients suggesting no benefit in the concomitant use of these drugs in clinical practice.References:[1]Simone Det al. J Rheumatol Suppl. 2015;93:65–9.Disclosure of Interests:None declared

scholarly journals Low Back Pain in Hidradenitis Suppurativa: A Diagnosis Not to Miss!

2018 ◽  
Vol 10 (2) ◽  
pp. 187-189
Author(s):  
Benjamin Schnebert ◽  
Véronique del Marmol ◽  
Farida Benhadou
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Hidradenitis Suppurativa ◽  
Combined Therapy ◽  
Skin Lesions ◽  
Skin Area ◽  
Low Back ◽  
Inflammatory Drugs ◽  
The Right ◽  
Altered Sensitivity

We report the case of a patient suffering from hidradenitis suppurativa since puberty and complaining of chronic low back pain associated to altered sensitivity and muscular weakness in the right leg. A diagnosis of lumbosciatica was confirmed. Symptoms were not relieved after the use of nonsteroidal anti-inflammatory drugs and analgesics. A surgical decompression was then indicated but heavily debated. Indeed, extended inflammatory and fibrotic hidradenitis suppurativa lesions were located regarding the skin area eligible for the proposed surgery. A combined therapy with clindamycine/rifampicin was started and the surgery was postponed. A complete remission of the articular symptoms was observed 1 month after the start of the antibiotherapy and the inflammatory skin lesions were greatly improved. With the presentation of this clinical case, we would like to discuss the spectrum of rheumatic disorders associated to hidradenitis suppurativa that needs to be correctly diagnosed and taken into consideration in the therapeutic management of the patient.

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