ABC of dermatology. Treatment of psoriasis.
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Various chemoattractants have been implicated in the aetiology of the polymorphonuclear leucocyte (PMN) migration into the epidermis seen in early lesions of psoriasis. Using an under-agarose technique, the in vitro chemotactic responses of PMN to the arachidonic acid lipoxygenase product leukotriene B4 (LTB4) were assayed in five groups of subjects: normal healthy volunteers (n = 12), untreated psoriatics (n = 11) and psoriatics treated with topical tar (n = 12), PUVA (n = 11) and UVB phototherapy (n = 10). No significant difference was observed between the responses of control subjects and of untreated psoriatics, nor between the untreated psoriatic group and the PUVA- and UVB-treated groups, respectively. However, comparison of the tar-treated and untreated groups revealed a significantly increased chemotactic response to LTB4 in the tar-treated group (p less than 0.01).
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The therapeutic effectiveness of a new fluorescent lamp, Philips TL-01, which emits a narrow peak around 311-312 nm, was compared with the currently used PUVA photochemotherapy consisting of oral 8-MOP followed 2 h later by UV-A from fluorescent lamps Philips TL-09. Comparisons of therapeutic efficacy were performed in 10 patients with widespread, symmetrically distributed psoriasis lesions. They received treatment with PUVA on one half of the body and with TL-01 light on the other half; both treatments were given twice a week. It is concluded that on the average phototherapy with narrow-band UV-B is an effective as PUVA; it is certainly more convenient and probably less carcinogenic.
The author gives grounds for future therapeutic and prophylactic application of physical factors' impact on blood (hemophysiotherapy). Today's opportunities of hemophysiotherapy and lines for future research are described.
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Combined aftercare with mud applications, sinusoidal modulated currents (SMC) and UV radiation of autoblood was compared to conventional drug therapy in 56 and 30 patients, respectively, having chronic prostatitis with reproductive dysfunction. It was found that the combined aftercare raises the treatment efficiency due to a favourable effect on the immune system, inflammation in the prostate and spermatogenesis. It also promotes long-term remission.
The authors report the results of an open study conducted on 53 patients with psoriasis treated by narrow-band UVB phototherapy, using Philips' TL01 lamp. With a simple procedure which did not require MED determination this treatment gave satisfactory results in 92 p. 100 of the cases, with mild burns in only 9 p. 100. The morphological type of psoriasis (patchy, guttate or nummular) had no influence on the therapeutic result, but the degree of infiltration of the lesions and their location on the lower limbs proved to be a factor of relative resistance. In most patients the results were obtained in 20 sessions with a mean cumulative dose of 20.19 +/- 2.7 J/cm2. Some patients had an additional treatment of 6 sessions. The results obtained with Philips' TL01 lamp were as satisfactory as those obtained with the conventional UVB lamps, but the TL01 lamp seemed to be easier to handle and better tolerated, which gives them some advantages over the latter.
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