Phototherapy for hypopigmented mycosis fungoides in Asians

Background: Hypopigmented mycosis fungoides (MF) is an uncommon variant of MF. It is rare in Caucasians but more common in young skin-of-color individuals. To date, there are only a few reports on UV-based treatment for this condition. Objectives: To analyze the efficacy of PUVA photochemotherapy and narrowband UVB (NBUVB) phototherapy for hypopigmented MF. Methods: A retrospective study of nine patients who received PUVA or NBUVB was performed. The clinical response, total number of treatments, cumulative UV doses, disease-free interval and adverse effects were recorded. Result: Eight patients had stage IA and one patient had stage IB. Six patients received NBUVB and three patients received PUVA. Three patients (50%) in the NBUVB group and three patients (100%) in the PUVA group had complete response (CR). Total UV dose to get maximal clinical response ranged from 27.1-59.6 J/cm2 in the NBUVB group and 244-669.1 J/cm2 in the PUVA group. In six patients who had CR, recurrence was found in four (66.7%), and the disease-free interval ranged from 2 months to 6 years. Conclusion: PUVA and NBUVB are effective for hypopigmented MF. Comparing between these two methods, PUVA provided a better response than NBUVB. Although the disease responded well to phototherapy, relapse was common.