NB-UVB (311-312 nm)-induced lentigines in patients with mycosis fungoides: a new adverse effect of phototherapy.

Type:Uv phototherapy   Time:2014-12-12 15:31:51
NB-UVB (311-312 nm)-induced lentigines in patients with mycosis fungoides: a new adverse effect of phototherapy.
Friedland R1, David M, Feinmesser M, Barzilai A, Hodak E.
Author information
Abstract
BACKGROUND:
Lentigines are a common pigmentary disorder in adults and in patients treated by psoralen and ultraviolet A (PUVA) radiation. 

Their appearance following treatment with narrow-band ultraviolet B (NB-UVB) radiation has been reported in only two 

patients.
OBJECTIVE:
To describe the clinical and histological features of NB-UVB-induced lentigines their relation to dosimetry and the course of 

the eruption in patients with mycosis fungoides (MF).
METHODS:
The files of all patients with MF treated in our department in 2003-2010 were searched to identify those in whom lentigines 

appeared following monotherapy with NB-UVB radiation.
RESULTS:
Of the 73 patients with early stage MF identified, 10 met the study criteria. Lentigines were detected in skin previously 

involved by MF in seven patients, and in both involved and uninvolved skin in three patients. They appeared during therapy in 

three patients, after a mean of 56 exposures (range 50-61), and several months (mean 7.8) following completion of treatment 

in seven patients, after a mean of 69 exposures (range 32-157). Histopathological study of lesions from five patients 

revealed basal hyperpigmentation relative to adjacent normal-looking skin. Two lesions had a slight increased number of 

normal-looking melanocytes on immunohistochemical staining with melanoma cocktail. One lesion had elongated rete ridges. The 

lesions persisted throughout follow-up (mean 26.7 months) in 8 patients.
CONCLUSIONS:
Patients with MF treated with NB-UVB may acquire lentigines. As opposed to PUVA-induced lentigines which are a known common 

side-effect of long-term treatment, NB-UVB-induced lentigines are uncommon but appear earlier, even after a few months of 

treatment.
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