Unilesional plantar mycosis fungoides treated with topical photodynamic therapy - case report and review of the literature

Abstract

Background

Unilesional mycosis fungoides (UMF) and pagetoid reticulosis (PR) are variants of mycosis fungoides. Conventional therapy comprises surgical excision or radiotherapy which may be associated with long-term side effects, especially when the lesion is located at a special site like the palms and soles. Therefore, alternative treatment options are needed to treat solitary lesions in the case of UMF or PR. Recently topical photodynamic therapy (PDT) has been described to be an efficient and non-invasive therapeutical option with excellent clinical outcome.

Objective

The objective of this paper is to report a 43-year old woman with plantar UMF treated successfully with PDT, and to compare our findings with the data on PDT in UMF and PR reported in the literature.

Methods

The literature was analyzed for articles on UMF and PR, respectively, treated with topical PDT. Various parameters including form of PDT and response to treatment were analyzed and compared with our case.

Results

A total of 24 patients were documented with 24 lesions treated with PDT, either using aminolevulinic acid (ALA) or methylaminolevulinate (MAL). In average a single lesion was treated 19 times with PDT. In 21 cases (88%) complete response could be achieved, whereas 3 cases (13%) showed partial remission. None of the cases showed a stable or progression of the disease.

Conclusions

PDT is a safe, efficient and non-invasive therapeutical approach for the treatment of UMF and PR. It has no longstanding adverse events and therefore is of high therapeutic value especially in cases of UMF and PR located at special sites like the palms and soles. We propose to include topical PDT as therapeutic options for the treatment of UMF and PR in future guidelines on MF.

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