Treatment of Mycosis Fungoides with Oral Bexarotene Combined with PUVA

Bexarotene has recently been approved in the United States and Europe as a single orally administered retinoid for the treatment of cutaneous T-cell lymphoma (CTCL) in patients who are refractory to at least one prior systemic therapy. We describe a 47-year old female with a 4-year history of mycosis fungoides (MF) who developed debilitating side effects from acitretin and PUVA, and subsequently responded to bexarotene 75 mg orally once daily combined with PUVA. Bexarotene has been approved at an optimal starting dose of 300 mg/m²/d but has not yet been approved for use in combination with PUVA. We used a low dose (75 mg) combined with PUVA in an attempt to minimize side effects while maintaining treatment efficacy. Our patient's response to a novel regimen of low dose bexarotene combined with PUVA has been excellent and suggests that this regimen may be a useful method for treatment of MF.