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Biomedical subjects

R S Dawe

Publications and source records attributed to R S Dawe.

52 records · Page 3Linked to original sources
PubMed1998

The photosensitivity dermatitis and actinic reticuloid syndrome (chronic actinic dermatitis) occurring in seven young atopic dermatitis patients.

Seven young patients with atopic dermatitis (AD) who presented with a marked photoexposed site dermatitis have been investigated in detail. The results of phototesting, patch testing and other investigations were compatible with the diagnosis of photosensitivity dermatitis/actinic reticuloid syndrome (PD/AR) (chronic actinic dermatitis). It is known that AD patients may have photoaggravation of their dermatitis or exacerbation secondary to a photodermatosis, such as polymorphic light eruption, actinic prurigo or drug-induced phototoxicity. The patients we describe, however, appear to be an uncommon AD subgroup affected by PD/AR. We recommend that all AD patients who have a history of sunlight-induced exacerbation or marked intolerance of PUVA or ultraviolet B phototherapy should have phototesting and patch testing conducted.

Adult↗
PubMed1998

Narrow-band (TL-01) ultraviolet B phototherapy for chronic plaque psoriasis: three times or five times weekly treatment?

Three and five times weekly narrow-band TL-01 (311-313 nm) ultraviolet (UV) B phototherapy regimens for chronic plaque psoriasis were compared in a randomized, observer-blinded, half-body, within-patient paired study. Twenty-one patients [13 men, eight women, age range 21-68 years, skin phototypes I (two patients), II (14) and III (five)] entered the study. Sixteen reached clearance or minimal residual activity (MRA) on both sides. Of the other five, three withdrew because they did not reach clearance or MRA on the 5x weekly side by a maximum of 30 treatments, one when he was satisfied with moderate improvement and one because of repeated failure to attend. Those who completed treatment reached clearance or MRA after a median of 35 days with 5x weekly treatment compared with 40 days with 3x weekly treatment (P = 0.007), but required a median of 23.5 compared with 17 UVB exposures (P = 0.001) and 94 minimal erythema dose multiples (MEDs) compared with 64 MEDs (P = 0.01). Fifteen (of 16) developed at least one episode of well-demarcated erythema during 5x weekly treatment compared with just three of 16 treated 3x weekly (P < 0.001). There was no significant difference between regimens in duration of remission. For this skin phototype I-III population, the more rapid clearance of psoriasis with 5x weekly phototherapy is not, for the majority of patients, sufficient to justify the extra exposures and higher UVB dose. We no longer use 5x weekly phototherapy for psoriasis.

Adult↗
PubMed1998

Multiple widespread eruptive Spitz naevi.

A 19-year-old man presented with a widespread eruption of several hundred Sptiz naevi. He is still developing new lesions, 4 years after the problem began. No treatment to date has been satisfactory. The literature on prognosis and treatment of this condition is reviewed.

Adult↗
PubMed1998

Narrowband ultraviolet B (TL-01) phototherapy for psoriasis: which incremental regimen?

Narrowband (311-313 nm) ultraviolet B phototherapy with the Philips TL-01 lamp is used increasingly in the treatment of psoriasis with little information available on the optimum irradiation regimen. We compared a high and a low incremental dose regimen in 20 patients with symmetrical chronic plaque psoriasis using a randomized half body study and thrice weekly exposures. Paired trunk, leg and arm plaques of psoriasis were scored blind prior to and at each treatment for scaling, erythema and induration. Patients were treated to clearance or minimal residual activity and followed up until relapse. The low increment regimen achieved a 10% reduction in the median cumulative dose to clearance (16,401 vs. 18,246 mJ/cm2) with one extra treatment in 50% of the patients. However, the duration of treatment (median 53.5 days) was identical for both regimens except for one patient because there were 50% fewer episodes of erythema requiring postponement of treatment with the low increment regimen. We now favour the low increment regimen for phototherapy in our psoriasis population.

Adult↗
PubMed1997

Prolonged benefit following ultraviolet A phototherapy for solar urticaria.

Two patients with severe idiopathic solar urticaria, previously resistant to a variety of therapies including plasma exchange, benefited from springtime courses of ultraviolet A (UVA) monotherapy. Sites which are normally exposed to sunlight were treated, in a cabinet fitted with Philips R-UVA lamps (emitting UVA and visible wavelengths, with peak at 350 nm), twice daily for 2-3 weeks. One patient has been treated in this way for 3, and the other for 2, consecutive years. Repeat monochromator phototesting 3 months after their latest courses of UVA showed a persistent reduction in severity of abnormal photosensitivity. Both patients describe a sustained improvement in their condition lasting over 6 months after treatment.

Adult↗
PubMedDate not supplied

Can a positive photopatch test be elicited by subclinical irritancy or allergy plus suberythemal UV exposure?

Photopatch test (PhPT) interpretation is difficult and clinical relevance is not always apparent. A positive PhPT may reflect photocontact allergy or phototoxicity. We hypothesized that it may also reflect the additive or synergistic effects of a suberythemal reaction to a contact irritant [e.g. sodium lauryl sulfate (SLS)] or allergen (e.g. nickel) and suberythemal UV exposure. 10 nickel allergic volunteers had duplicate SLS and nickel series applied on either side of the back for 24 h and 48 h, respectively. After removal, one side was irradiated with 5 J/cm(2) UVA or the dose below the minimal erythema dose for solar-simulated radiation (SSR). The minimal irritancy dose (MID) for SLS and the minimal allergenic dose (MAD) for nickel were determined visually and objectively by erythema meter. While photoaugmentation of subclinical contact allergy or irritancy occurred in some subjects, photosuppression occurred in roughly an equal number. UVA changed the nickel MAD at 48 h in 2 of 5 volunteers but not the SLS MID. SSR changed the nickel MAD in 4 of 5 and the SLS MID in 3 of 5. 2 subjects (none after UVA) showed erythema only in the irradiated set of patches, which could have been interpreted as a positive PhPT. We have demonstrated photoaugmentation and photosuppression of contact allergy and irritancy, which could result in false-positive or false-negative interpretation of PhPTs.

Adolescent↗
PubMedDate not supplied

Artificial hardening for polymorphic light eruption: practical points from ten years' experience.

The conservative approach of sunlight avoidance and broad-spectrum sunscreen is often disappointing in patients with moderate to severe polymorphic light eruption. A springtime course of prophylactic artificial hardening with ultraviolet B (UVB) phototherapy or psoralen plus ultraviolet A (PUVA) photochemotherapy will often allow patients to tolerate more sunlight and give them greater freedom during the summer. In this retrospective study we describe ten years' experience of such "desensitization" treatment. Individualized therapy with attention to detail will maximize the effectiveness of this treatment.

Adolescent↗