Photochemotherapy for mycosis fungoides: current status

Phototherapy for mycosis fungoides is reviewed with particular emphasis on PUVA (psoralen ultraviolet A-range) therapy and its combination with other topical and systemic treatments. PUVA therapy has the advantages of being available in all major centres, is simple to administer, relatively inexpensive and has relatively low toxicity. Medium-term results suggest that PUVA is as effective as any of the other topical therapies for stage I disease. Its combination with alpha-interferon produces significant benefit in stage II or more advanced disease. Long-term non-melanoma skin cancer is increased with PUVA and combination PUVA usage, but melanoma is not increased. Its long-term position in comparison to other therapies with regard to morbidity, mortality and quality of life needs further evaluation.