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Biochemical Changes Observed After PUVA Versus PUVA Plus Methotrexate Therapy in Mycosis Fungoides Using Synchrotron Infrared Microspectroscopy

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Abstract

Mycosis fungoides (MF) is the most common type of cutaneous T cell lymphoma in which the distinction between early stage MF and other inflammatory dermatosis remains difficult. Twenty patients of early stage MF and nine patients with psoriasis and lichen planus were included in this study. Ten MF patients were treated with psoralen plus UVA (PUVA) and the other 10 MF patients were treated with PUVA plus methotrexate (MTX) until complete clinical remission. Synchrotron infrared microspectroscopy (SIRM) found that MF lesions were biochemically different compared to inflammatory diseases. After treating MF with either therapeutic modality, the lymphocytic count decreased significantly in both the epidermis and dermis (P < 0.001) but no biochemical changes were observed in the remaining lymphocytes after treatment, indicating the disease process was slowed by treatment but not eradicated. In conclusion SIRM is a promising method for distinguishing MF from other inflammatory diseases such as psoriasis and lichen planus. A significant reduction in lymphocyte count indicated that PUVA therapy is an effective treatment for early stage MF, and MTX could be reserved for more advanced cases that are not PUVA responsive. However, SIRM evidence of persistent disease suggests that maintenance therapy is recommended after clinical remission.

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Acknowledgments

Special thanks for the US Department of Energy (DOE) Cooperative Research Program for SESAME for supporting this work.

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Authors and Affiliations

  1. National Center for Radiation Research and Technology, Cairo, Egypt

    Ahmed E. L. Bedewi

  2. Dermatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

    Randa Youssef, Dalia M. Abdel Halim, Rehab A. Hegazy & Medhat E. L. Mofty

  3. Brookhaven National Laboratory, National Synchrotron Light Source, Upton, New York, NY, USA

    Ahmed E. L. Bedewi, William Willis & Lisa M. Miller

  4. Histology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

    Safinaz S. Sayed

Authors
  1. Ahmed E. L. Bedewi
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  2. Randa Youssef
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  3. Dalia M. Abdel Halim
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  4. Rehab A. Hegazy
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  5. William Willis
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  6. Lisa M. Miller
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  7. Safinaz S. Sayed
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  8. Medhat E. L. Mofty
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Correspondence to Ahmed E. L. Bedewi.

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Bedewi, A.E.L., Youssef, R., Halim, D.M.A. et al. Biochemical Changes Observed After PUVA Versus PUVA Plus Methotrexate Therapy in Mycosis Fungoides Using Synchrotron Infrared Microspectroscopy. Int J Pept Res Ther 19, 209–215 (2013). https://doi.org/10.1007/s10989-012-9336-6

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  • DOI: https://doi.org/10.1007/s10989-012-9336-6

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