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Bath Psoralen-ultraviolet A and Narrowband Ultraviolet B Phototherapy as Initial Therapy for Early-stage Mycosis Fungoides: A Retrospective Cohort of 267 Cases at the University of Toronto.

Almohideb M¹, Walsh S², Walsh S², Shear N², Alhusayen R².

Author information

1 Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: moalm20@gmail.com.

2 Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.

Abstract

BACKGROUND:

Phototherapy is used frequently to treat early-stage mycosis fungoides (MF). The effectiveness of bath psoralen-ultraviolet A (bath PUVA) and narrowband ultraviolet B (nbUVB) in MF is well established. However, evidence is limited comparing the effectiveness of the 2 modalities for early-stage MF. The objective of the present study was to compare the responses between the study participants receiving bath PUVA versus nbUVB phototherapy.

PATIENTS AND METHODS:

The study included a retrospective cohort of stage 1A and 1B MF patients treated with bath PUVA or nbUVB at their initial presentation. The primary outcome was the response to treatment. The secondary outcome was disease-free survival.

RESULTS:

The cohort included 267 patients (158 treated with bath PUVA and 109 treated with nbUVB) with a mean age of 45.22 years. The mean follow-up period was 59.58 months for bath PUVA and 22.27 months for nbUVB. Overall, 88.61% of the bath PUVA group and 88.07% of the nbUVB group had complete responses (P = .89). The median number of treatments to achieve a complete response was 55 for bath PUVA and 55.5 for nbUVB (P = .63). The median disease-free survival was 43.25 months for bath PUVA and 14.9 months for nbUVB (P < .0001). The study was limited by its retrospective nature.

CONCLUSION:

Bath PUVA and nbUVB are both effective treatments. The use of bath PUVA resulted in significantly greater disease-free survival.

Copyright © 2017 Elsevier Inc. All rights reserved.

Full article available in the Journal of Dermatology Nurses' Association

Nurses’ Experience Removing Superficial Nonabsorbable Sutures From the Skin: Wound Overgrowth of Sutures Complicates the Procedure

Akeroyd, Jennifer; Kitada, Heather H.; Plauntz, Leslie; Lear, William

Journal of the Dermatology Nurses' Association . 9(1):16-20, January/February 2017.

ABSTRACT: In many dermatology settings, nurses remove superficial sutures from wounds of the skin. The current practice is to remove sutures between 5 and 14 days depending on the location of the defect to prevent wound overgrowth and subsequent complications. Yet, by 10 days, wound strength is only 5% of that of intact skin, also setting the stage for potential complications, such as dehiscence. We surveyed Dermatology Nurses’ Association members to understand their experiences with removing sutures from the skin. With a response rate of 16.75%, the sample size was 355 respondents. Over 90% of the respondents encountered wound overgrowth (i.e., ingrown sutures) when removing sutures. Moreover, mattress-type closures presented more difficulty on removal than simple-type closures. When sutures were ingrown, complications included patient pain (31.5%), wound bleeding (30.1%), inability to ensure the complete removal of sutures (19.2%), wound dehiscence (7.0%), and increased procedure time by nearly 2 minutes. Our findings of nurse experiences with suture removal support the need for innovative solutions to prevent wound overgrowth.