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Títol:	First-line treatment in lymphomatoid papulosis: a retrospective multicentre study
Autor/a:	Fernández de Misa, Ricardo; Hernández Machín, B.; Servitje Bedate, Octavio; Valentí Medina, Francesc; Maroñas Jiménez, L.; Ortiz Romero, Pablo L.; Sánchez Schmidt, Júlia; Pujol, Ramon M.; Gallardo, Fernando; Pau Charles, I.; Garcia-Muret, Maria P.; Pérez Gala, S.; Román, Concepción; Cañueto, J.; Blanch Rius, L.; Izu, Rosa; Ortiz Brugués, Ariadna; Martí, Rosa M.; Blanes, M.; Morillo, Mercedes; Sánchez, P.; Peñate, Yerai; Bastida, J.; Pérez Gil, Amalia; Lopez Lerma, Ingrid; Muniesa Montserrat, Cristina; Estrach Panella, Ma. Teresa (María Teresa)
Notes:	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.
Matèries:	-Limfomes -Malalties de la pell -Fototeràpia -Lymphomas -Skin diseases -Phototherapy
Drets:	(c) British Association of Dermatologists, 2017
Tipus de document:	Article Article - Versió acceptada
Publicat per:	Wiley
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