Topical 5‐aminolevulinic acid photodynamic therapy for the treatment of unilesional mycosis fungoides: a report of two cases and review of the literature

BACKGROUND: Unilesional mycosis fungoides (MF) is a rare variant of cutaneous T-cell lymphoma (CTCL), characterized clinically by a solitary lesion and by histopathological features indistinguishable from multilesional MF. The photodynamic therapy (PDT) is a new and effective treatment of precancerous lesions and non-melanoma skin cancers. In recent years it has been used successfully for the treatment of MF. METHODS: We present two cases of unilesional MF treated with 5-Aminolevulinic acid-PDT (ALA-PDT). We used twenty per cent ALA, applied topically to the lesion, and a well defined laser irradiation at 585 nm wavelength from C-Beam laser. Treatment was repeated three times at monthly intervals. Skin biopsies were taken before and after therapy. RESULTS: Both patients showed clinical remission. The biopsies confirmed a regression of the infiltrate after treatment. CONCLUSIONS: PDT is effective and can be used successfully for MF treatment, particularly for patch and plaque stage MF, including unilesional MF.