Quality of Life, Anxiety, and Depression in Patients With Early-Stage Mycosis Fungoides and the Effect of Oral Psoralen Plus UV-A (PUVA) Photochemotherapy on it

Frontiers in Medicine

article

Thomas Graier¹  Angelika Hofer¹  Alexandra Gruber-Wackernagel¹  Franz J. Legat¹  Pablo Augusto Vieyra-Garcia¹  Franz Quehenberger²  Peter Wolf¹  Regina Fink-Puches¹  Stephanie Porkert³  Roland Lang⁴  Sophie Pöchlauer⁵  Gudrun Ratzinger⁶  Adrian Tanew³  Sylvia Selhofer⁴  Paul-Gunther Sator⁵ 

[1] Research Unit for Photodermatology, Department of Dermatology and Venereology, Medical University of Graz;Institute for Medical Informatics, Medical University of Graz;Department of Dermatology, Medical University of Vienna;Department of Dermatology and Allergology, Paracelsus Medical University;Department of Dermatology, Hietzing Hospital;Department of Dermatology Venereology and Allergology, Medical University of Innsbruck

关键词: mycosis fungoides;    quality of life;    anxiety;    depression;    PUVA;    phototherapy;   

DOI  :  10.3389/fmed.2020.00330

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: Little is known about psychological discomfort and quality of life (QoL) in early stage mycosis fungoides (MF) and the effect of psoralen plus UV-A (PUVA) on it. Objective: To evaluate QoL, anxiety, and depression with validated instruments in early stage MF patients and whether PUVA treatment improves it. Methods: Patients with stage IA to IIA MF were treated with PUVA twice weekly for 12–24 weeks, followed by maintenance treatment or not, in a prospective randomized clinical trial. Patients completed a questionnaire on DLQI as well as the Hospital Anxiety and Depression Scale (HADS) prior to therapy, after their last PUVA exposure, and after the PUVA maintenance or observance phase. Results: For 24 patients with early stage MF, completed questionnaires were available and analyzed. Prior to treatment, 17% reported strong (DLQI > 10) and 29% moderate impairment (DLQI 6–10) in QoL; 33% of patients reported HADS scores indicating anxiety, and 21% reported scores indicating depression. PUVA significantly improved overall QoL by reducing mean DLQI scores by 58.6% ( p = 0.003), HADS-A by 30% ( p = 0.045), and HADS-D by 44% ( p = 0.002). Improvements in QoL and psychological well-being seemed to be sustained, irrespective of maintenance treatment or not. Limitations: Small sample size. Conclusions: PUVA sustainably improves QoL and psychological well-being in patients with early stage MF. Clinical trial registration:ClinicalTrials.gov identifier: {"type":"clinical-trial","attrs":{"text":"NCT01686594","term_id":"NCT01686594"}} NCT01686594 .

【 授权许可】

CC BY