The impact of environmental ultraviolet exposure on the clinical course of mycosis fungoides

J Am Acad Dermatol. 2019 Nov;81(5):1074-1077. doi: 10.1016/j.jaad.2019.02.010. Epub 2019 Feb 11.

Abstract

Background: As phototherapy plays an important role in the treatment of early-stage mycosis fungoides (MF), it is possible that environmental ultraviolet (UV) exposure affects the natural history of the disease.

Objective: To assess the impact of environmental UV exposure on the clinical course of MF.

Methods: The National Solar Radiation Database was used to identify the top and bottom registries for UV exposure from the Surveillance, Epidemiology, and End Results-18 database. Incidence and survival were determined.

Results: The high-UV cohort had a 30% lower risk of developing MF than did the low-UV cohort (hazard ratio, 1.3; 95% confidence interval, 1.20-1.41; P < .001). When stratified by stage and race, this difference was appreciable only among those with early-stage disease and white race. There was no difference in survival between the high- and low-UV cohorts (P = .098); however, a small difference was observed among those with early-stage disease and white race, favoring high UV exposure.

Limitations: Retrospective design, use of the National Solar Radiation Database as a surrogate for individual sunlight exposure.

Conclusion: It is possible that environmental solar UV exposure may play a role in controlling early-stage MF among patients with photosensitive features.

Keywords: mycosis fungoides; phototherapy; ultraviolet light.

MeSH terms

  • Adult
  • Aged
  • Environmental Exposure / adverse effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycosis Fungoides / etiology*
  • Retrospective Studies
  • Skin Neoplasms / etiology*
  • Ultraviolet Rays / adverse effects*