Quality of Life, Anxiety, and Depression in Patients With Early-Stage Mycosis Fungoides and the Effect of Oral Psoralen Plus UV-A (PUVA) Photochemotherapy on it

Background: Little is known about psychological discomfort and quality of life (QoL) in early-stage mycosis fungoides (MF) and the effect of psoralen plus UV-A (PUVA) on it. Objective: To evaluate QoL, anxiety and depression with validated instruments in early-stage MF patients and whether PUVA-treatment improves it. Methods: Patients with stage IA to IIA MF were treated with PUVA twice weekly for 12-24 weeks, followed by maintenance treatment or not, in a prospective randomized clinical trial. Patients completed questionnaire on DLQI as well as the Hospital Anxiety and Depression Scale (HADS) prior to therapy, after last PUVA exposure and after PUVA maintenance or observance phase. Results: For 24 patients with early-stage MF completed questionnaires were available and analyzed. Prior to treatment, 17% reported strong (DLQI:>10) and 29% moderate impairment (DLQI:6-10) in QoL. 33% of patients reported HADS scores indicating anxiety and 21% reported scores indicating depression. PUVA significantly improved overall QoL by reducing mean DLQI score by 58.6% (p=0.003), HADS-A by 30% (p=0.045) and HADS-D by 44% (p=0.002). Improvements in QoL and psychological wellbeing seemed to be sustained, irrespective of maintenance treatment or not. Limitations: Small sample size. Conclusions: PUVA sustainably improves QoL and psychological wellbeing in patients with early-stage MF.