ABSTRACT
Phototherapy using narrowband ultraviolet B (UVB) is considered among the treatments of choice in vitiligo, even in childhood. The objective of the current study was to evaluate the profile of safety and effectiveness of such therapy in a group of children. An open, uncontrolled study was performed on 28 children with vitiligo who were receiving narrow band UVB phototherapy. The children were classified according to vitiligo type and phototype. Family history and presence of thyroid disease were investigated. Eighteen patients had received other treatments that was stopped 3 months before starting phototherapy. Phototherapy was administered twice a week. The mean duration of therapy was 10 ± 3.4 months. The mean total dose administered was 156.12 ± 79.4 J/cm(2). Photographs of lesions were taken before and at the end of treatment. The response to phototherapy was expressed as percentage of repigmentation. The data were statistically analyzed using SPSS (SPSS Inc., Chicago, IL). Fourteen percent of patients showed excellent response, 28.6% good response, 25% moderate response, and 28.6% mild response; the remaining 3.5% were not responsive. No side effects were observed except mild erythema requiring a decrease in dosage in a few patients. The results of the present study confirm those of other authors, with better results than adults probably related to good adherence of patients and their families. Nevertheless, high cumulative doses are not necessarily related to a good response. Therefore, we suggest stopping treatment after 6 months in nonresponding cases.
Subject(s)
Ultraviolet Therapy/methods , Vitiligo/radiotherapy , Adolescent , Child , Child, Preschool , Erythema/etiology , Female , Humans , Male , Skin Pigmentation , Treatment Outcome , Ultraviolet Therapy/adverse effectsABSTRACT
BACKGROUND: Mycosis fungoides (MF) minimal disease stage IA, characterized by one or few close lesions (up to four), has been considered a distinct entity with a favourable prognosis, where local treatment such as radiotherapy could afford long-lasting remissions. OBJECTIVE: To review our experience in radiologic treatment of this subset of the disease and compare our results with those reported in the literature. METHODS: Fifteen patients presenting with MF minimal disease were treated with localized superficial X-ray therapy, with a total median dose of 22 Gy. RESULTS: At 1 month from the end of radiotherapy, complete remission was observed in 95.45% of irradiation fields and partial remission in 4.54%. The 5-year local progression-free rate was 93.75%, while the overall relapse-free rate at 5 and 10 years was 51%. CONCLUSIONS: After an excellent response to radiotherapy, MF minimal disease may experience local or distant failures, even after years. The identification of an optimal dose of radiation and the collection of more cases would be useful in giving new guidelines in the treatment of this subset of the disease.
Subject(s)
Mycosis Fungoides/pathology , Mycosis Fungoides/radiotherapy , Neoplasm Recurrence, Local/pathology , Skin Neoplasms/pathology , Skin Neoplasms/radiotherapy , Adolescent , Adult , Age Factors , Aged , Child , Cohort Studies , Disease Progression , Dose-Response Relationship, Radiation , Female , Follow-Up Studies , Humans , Male , Middle Aged , Mycosis Fungoides/mortality , Neoplasm Recurrence, Local/mortality , Neoplasm Staging , Radiotherapy Dosage , Retrospective Studies , Risk Assessment , Sex Factors , Skin Neoplasms/mortality , Survival Rate , Time Factors , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: The nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin-Goltz syndrome, is a rare dermatological disease inherited according to an autosomal dominant pattern. From the dermatological point of view, the most evident characteristic of the syndrome is the early onset of multiple basal cell carcinomas (BCCs). An ideal treatment of BCCs of the NBCCS does not exist. OBJECTIVE: To evaluate if in particular cases (e.g. poor general health conditions, previous multiple surgical excisions) radiotherapy may be useful, under the condition that it does not promote the onset of new BCCs and that the healing of irradiated lesions is normal. METHODS: A study on 3 patients with 17 BCCs treated with superficial radiotherapy is here reported. RESULTS: Complete remission without carcinogenic effects was reached in all treated lesions, with a mean follow-up of 30.35 months. CONCLUSION: In our opinion, such results suggest the possibility of a cautious application of superficial radiotherapy in selected cases of NBCCS.
