To determine the effectiveness of topical corticosteroids in the management of mycosis fungoides.
Prospective study.
Academic referral center, Veterans Affairs Medical Center, and private practice.
...Seventy-nine patients with patch or plaque stage of mycosis fungoides. Fifty-one were stage T1 (less than 10% of skin involved) and 28 were stage T2 (10% or more of skin involved). Seventy-five had patch-stage and 4 had plaque-stage disease as determined by histological examination.
Patients were treated with topical class I to III corticosteroids. Of the stage T1 patients, all used class I corticosteroids, and 4 (8%) also used class II or III corticosteroids. Of the stage T2 patients, 19 (68%) used class I and 12 (43%) used class II or III compounds. Some patients used more than 1 class of corticosteroid. Applications were almost always twice daily. Three stage T1 and 2 stage T2 patients used plastic film occlusion. Baseline and monthly morning serum cortisol levels were obtained during treatment.
Response to treatment and side effects.
The median follow-up period was 9 months. Thirty-two (63%) of stage T1 patients achieved complete remission and 16 (31%) achieved partial remission, for a total response rate of 48 (94%). The comparable figures for stage T2 patients were 7 (25%), 16 (57%), and 23 (82%), respectively. Responses were determined by clinical examination. Thirty-nine patients achieved clinical clearing. In 7 of these, posttreatment biopsy specimens were obtained, and all showed histological clearing. Reversible depression of serum cortisol levels occurred in 10 (13%). Minor skin irritation occurred in 2 patients and localized, reversible skin atrophy in 1.
Topical corticosteroids, especially class I compounds, are an effective treatment for patch-stage mycosis fungoides.
On September 17, 2000, the Ministry of Agriculture and Irrigation (MAI) and Ministry of Health (MOH) of Yemen received reports about the occurrence of disease compatible with Rift Valley fever (RVF) ...in El Zuhrah district of Hodeidah governorate. Reports of animal disease included abortions and deaths in young animals. Surveillance efforts by MOH and MAI documented widespread disease among humans and animals in the area of Wadi Mawr in El Zuhrah district, which is located on a coastal plain that extends from the southern tip of Yemen into the Jizan area of the Kingdom of Saudi Arabia (KSA). The Saudi Arabian Ministry of Health has described a simultaneous outbreak of RVF in the Jizan area in KSA (1,2). This report summarizes the investigation of the Yemen outbreak.
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