Narrow band UVB (311 nm), psoralen UVB (311 nm) and PUVA therapy in the treatment of early-stage mycosis fungoides: a right-left comparative study

Background: Psoralen ultraviolet A (PUVA) is a widely used first‐line therapy for treatment of early cutaneous T‐cell lymphoma. Narrow band UVB (UVB‐NB) (311 nm) has been recently introduced as another effective line of treatment. It is postulated that the efficacy of UVB‐NB could be enhanced by addition of psoralen. Aim: The aim of the present work was to compare the clinical and histopathologic efficacy of PUVA and UVB‐NB in the treatment of early‐stage MF (stages IA, IB and IIA), and to evaluate whether psoralen adds to the efficacy of UVB‐NB or not. Patients and Methods: Twenty patients (stage IA, IB or IIA) were divided into two equal groups: group I received UVB‐NB on the right body half vs. PUVA on the left side of the body for 48 sessions, and group II received PUVB‐NB on the right side of the body vs. PUVA on the left side for 36 sessions. The sessions were administered three times weekly. Results: In group I, almost equal results were obtained on both sides, i.e., UVB‐NB and PUVA were equally effective in the treatment of early stages of MF, both clinically and histopathologically. In group II, PUVB‐NB was found to be as effective as conventional PUVA in the treatment of early‐stage mycosis fungoides, also on both clinical and histopathological grounds. Conclusion: UVB‐NB phototherapy should be included among the initial therapeutic options of mycosis fungoides in view of its efficacy, convenience, and likelihood of fewer long‐term adverse effects. Addition of psoralen does not seem to enhance its therapeutic efficacy.