Terapêutica Fotodinâmica com metil-aminolevulinato no tratamento de lesões refractárias de Micose Fungóide: resposta clínica e histológica mantida em dois doentes
Abstract
According to the guidelines proposed by the National Comprehensive Cancer Network, early-stage Mycosis Fungoides (MF) should be treated with skin-directed therapies such as topical steroids or retinoids, topical chemotherapy (carmustin and nitrogen mustard), photochemotherapy, and superficial radiotherapy. Patients with refractory lesions to these therapeutic options are particularly challenging. Photodynamic Therapy (PDT) has been approved to treat cutaneous neoplastic and pre-neoplastic lesions such as superficial basal cell carcinoma, Bowen disease and actinic keratosis. Recently, several small studies have demonstrated the efficacy of PDT with methyl-aminolaevulinate (MAL) in the treatment of early-stage MF. We report two patients diagnosed with IA and IB MF, previously treated with conventional treatments (topical steroids and photochemotherapy) with short-term recurrence that were treated with PDT with MAL with complete and maintained response for one year. Our findings confirm that PDT with MAL can be one more palliative option in the treatment of early-stage MF, especially in pauci-lesional disease or in lesions resistant or inaccessible to conventional therapies.