First-line treatment in lymphomatoid papulosis: a retrospective multicentre study

R. Fernández-de-Misa, B. Hernández-Machín, O. Servitje, F. Valentí-Medina, L. Maroñas-Jiménez, P. L. Ortiz-Romero, J. Sánchez Schmidt, R. M. Pujol, F. Gallardo, I. Pau-Charles, M. P. García Muret, S. Pérez Gala, C. Román, J. Cañueto, L. Blanch Rius, R. Izu, A. Ortiz-Brugués, R. M. Martí, M. Blanes, M. MorilloP. Sánchez, Y. Peñate, J. Bastida, A. Pérez Gil, I. Lopez-Lerma, C. Muniesa, T. Estrach

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Abstract

© 2017 British Association of Dermatologists Background: Data regarding response to treatment in lymphomatoid papulosis (LyP) are scarce. Aim: To assess the daily clinical practice approach to LyP and the response to first-line treatments. Methods: This was a retrospective study enrolling 252 patients with LyP. Results: Topical steroids, methotrexate and phototherapy were the most common first-line treatments, prescribed for 35%, 20% and 14% of the patients, respectively. Complete response (CR) was achieved in 48% of treated patients. Eczematous lesions significantly increased relative risk (RR) of not achieving CR (RR = 1.76; 95% CI 1.16–2.11). Overall median time to CR was 10 months (95% CI 6–13 months), and 78% of complete responders showed cutaneous relapse; both results were similar for all treatment groups (P > 0.05). Overall estimated median disease-free survival (DFS) was 11 months (95% CI 9–13 months) but DFS for patients treated with phototherapy was 23 months (95% CI 10–36 months; P < 0.03). Having the Type A LyP variant (RR = 2.04; 95% CI 0.96–4.30) and receiving a first-line treatment other than phototherapy (RR = 5.33; 95% CI 0.84–33.89) were significantly associated with cutaneous early relapse. Of the 252 patients, 31 (13%) had associated mycosis fungoides unrelated to therapeutic approach, type of LyP or T-cell receptor clonality. Conclusions: Current epidemiological, clinical and pathological data support previous results. Topical steroids, phototherapy and methotrexate are the most frequently prescribed first-line treatments. Although CR and cutaneous relapse rates do not differ between them, phototherapy achieves a longer DFS. Presence of Type A LyP and use of topical steroid or methotrexate were associated with an increased risk of early relapse.
Original languageEnglish
Pages (from-to)137-143
JournalClinical and Experimental Dermatology
Volume43
Issue number2
DOIs
Publication statusPublished - 1 Mar 2018

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    Fernández-de-Misa, R., Hernández-Machín, B., Servitje, O., Valentí-Medina, F., Maroñas-Jiménez, L., Ortiz-Romero, P. L., Sánchez Schmidt, J., Pujol, R. M., Gallardo, F., Pau-Charles, I., García Muret, M. P., Pérez Gala, S., Román, C., Cañueto, J., Blanch Rius, L., Izu, R., Ortiz-Brugués, A., Martí, R. M., Blanes, M., ... Estrach, T. (2018). First-line treatment in lymphomatoid papulosis: a retrospective multicentre study. Clinical and Experimental Dermatology, 43(2), 137-143. https://doi.org/10.1111/ced.13256