A phase II placebo-controlled study of photodynamic therapy with topical hypericin and visible light irradiation in the treatment of cutaneous T-cell lymphoma and psoriasis

J Am Acad Dermatol. 2010 Dec;63(6):984-90. doi: 10.1016/j.jaad.2010.02.039.

Abstract

Background: Hypericin is a known photodynamic agent that has been demonstrated to induce apoptosis in normal and malignant B and T lymphocytes, and has potential to treat benign and malignant disorders of the skin, including psoriasis and cutaneous T-cell lymphoma.

Objective: We wished to test whether topical hypericin was an effective, safe, and well-tolerated therapy for patch or plaque phase mycosis fungoides and for plaque psoriasis.

Methods: We conducted a phase II placebo-controlled clinical study in patients who had either patch or plaque phase mycosis fungoides or plaque type psoriasis vulgaris. Representative lesions were treated twice weekly for 6 weeks with topically applied hypericin or placebo followed 24 hours later by exposure to visible light at 8 to 20 J/cm(2).

Results: After 6 weeks of twice-weekly therapy, several concentrations of hypericin resulted in the significant improvement of treated skin lesions among the majority of patients with cutaneous T-cell lymphoma and psoriasis whereas the placebo vehicle was ineffective.

Limitations: The clinical trial involved a small number of patients.

Conclusions: Overall, the data from this study support the conclusion that topical hypericin/visible light photodynamic therapy is an effective and well-tolerated alternative to standard psoralen plus ultraviolet A treatment of these disorders.

Publication types

  • Clinical Trial, Phase II
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Administration, Topical
  • Adolescent
  • Adult
  • Aged
  • Anthracenes
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Female
  • Humans
  • Light*
  • Lymphoma, T-Cell, Cutaneous / complications
  • Lymphoma, T-Cell, Cutaneous / drug therapy*
  • Male
  • Middle Aged
  • Perylene / administration & dosage
  • Perylene / adverse effects
  • Perylene / analogs & derivatives*
  • Photochemotherapy / adverse effects
  • Photochemotherapy / methods*
  • Phototherapy / adverse effects
  • Placebos
  • Psoriasis / complications
  • Psoriasis / drug therapy*
  • Skin Neoplasms / complications
  • Skin Neoplasms / drug therapy*
  • Treatment Outcome
  • Young Adult

Substances

  • Anthracenes
  • Antineoplastic Agents
  • Placebos
  • Perylene
  • hypericin