AUTHOR=Graier Thomas , Fink-Puches Regina , Porkert Stephanie , Lang Roland , Pöchlauer Sophie , Ratzinger Gudrun , Tanew Adrian , Selhofer Sylvia , Sator Paul-Gunther , Hofer Angelika , Gruber-Wackernagel Alexandra , Legat Franz J. , Vieyra-Garcia Pablo Augusto , Quehenberger Franz , Wolf Peter 

TITLE=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

JOURNAL=Frontiers in Medicine

VOLUME=7

YEAR=2020

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2020.00330

DOI=10.3389/fmed.2020.00330

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> 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.</p><p><bold>Objective:</bold> To evaluate QoL, anxiety, and depression with validated instruments in early stage MF patients and whether PUVA treatment improves it.</p><p><bold>Methods:</bold> 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.</p><p><bold>Results:</bold> For 24 patients with early stage MF, completed questionnaires were available and analyzed. Prior to treatment, 17% reported strong (DLQI &gt; 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% (<italic>p</italic> = 0.003), HADS-A by 30% (<italic>p</italic> = 0.045), and HADS-D by 44% (<italic>p</italic> = 0.002). Improvements in QoL and psychological well-being seemed to be sustained, irrespective of maintenance treatment or not.</p><p><bold>Limitations:</bold> Small sample size.</p><p><bold>Conclusions:</bold> PUVA sustainably improves QoL and psychological well-being in patients with early stage MF.</p><p><bold>Clinical trial registration:</bold><ext-link ext-link-type="uri" xlink:href="https://ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link> identifier: NCT01686594.</p>