Unilesional mycosis fungoides treated with photodynamic therapy. A case report

Mycosis fungoides, or cutaneous T-cell lymphoma (CTCL), is one of the most common skin lymphomas, with a chronic and lethal course. It is characterized by the expansion of CD4+ and CDw29+ immunophenotype T-cell clones lacking normal antigens. These altered T-lymphocytes are predominantly located in the skin, but some of them retain their ability to migrate and exit the skin through the lymphatics into the circulatory system.

We report on a 78-year-old man with an 8-year history of histologically verified Mycosis fungoides. Twenty-five years ago, the patient was incorrectly diagnosed with psoriasis vulgaris and received therapy with only slight effect. In 1999 the patient underwent full body actinotherapy (30 Gy) which resulted in complete remission of CTCL lesions on the skin. In October 2005 the patient presented at our department with a new partially infiltrated lesion 14x6 cm in his right groin. Because photochemotherapy and local therapy with corticosteroids had already been used without significant results, we opted for photodynamic therapy (PDT) with methyl aminolevulinate (MAL).