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At least 343 records · Page 19Linked to original sources
PubMed2005

Narrow-band ultraviolet B phototherapy in patients with psoriasis: for which types of psoriasis is it more effective?

Narrow-band ultraviolet B phototherapy with Philips TL-01 lamps is being used increasingly in the treatment of psoriasis. However, the effectiveness of phototherapy with narrow-band ultraviolet B in different clinical types of psoriasis vulgaris has not yet been evaluated in the literature. In the present study, we aimed to determine the efficacy and safety of narrow-band ultraviolet B therapy for different clinical forms of psoriasis vulgaris in our patient population. In this open study, 53 patients with psoriasis vulgaris, skin types II--IV, were enrolled. The patients were classified as guttate, nummular, plaque, or mixed according to their predominant morphological lesions. Evaluation of therapeutic efficacy was performed by comparing their Psoriasis Area and Severity Index (PASI) scores before and after treatment. The cumulative dose and the number of treatments were also calculated. Side effects were noted during the therapy. With respect to the different types of psoriasis, reductions of the PASI were not significantly different (p>0.05). The mean cumulative dose and total sessions in the plaque-type group were greater than those in the guttate and nummular groups (p<0.01, p<0.05). Complete clearing was observed in all patients in the guttate-type group, but the result was not statistically significant (p=0.064). Side effects were reported in five (11%) patients. During the 12 months follow-up period, there were no statistically significant differences in the relapse of the disease among the psoriasis groups (p=0.317). In conclusion, we found that the efficacy of narrow-band ultraviolet B therapy in patients with psoriasis decreased as the predominant lesion size enlarged. Before considering narrow-band ultraviolet B therapy for psoriasis, assessment of lesion size may be useful. Combination therapies may be more effective than phototherapy alone if the patient has predominantly large plaques.

Adolescent↗
PubMed1980

The cardiovascular stress of photochemotherapy (PUVA).

The recently devised therapy for psoriasis and related skin diseases, consisting of long-wave ultraviolet light and oral 8-methoxypsoralen (PUVA), was investigated for its cardiovascular effects. In seventeen patients, long-wave ultraviolet light therapy in a treatment enclosure (mean duration, 19.3 minutes) resulted in ambient temperatures of 39.2 degrees C +/- 2.1 degrees C (SD) and skin temperatures of 38.2 degrees C +/- 1.4 degrees C. In upright subjects, heart rate rose 30.8% to 114.4 +/- 25.2 beats per minute (bpm). Intensive room air conditioning, outside of the treatment enclosure, although significantly lowering skin and ambient temperatures, did not affect the heart rates significantly. PUVA therapy is associated with a definite cardiovascular stress when the box type of therapeutic unit is used. Possible modifications are discussed.

Adult↗
PubMed2000

Photoadaptation to ultraviolet (UV) radiation in vivo: photoproducts in epidermal cells following UVB therapy for psoriasis.

BACKGROUND: Ultraviolet (UV) radiation is mutagenic and induces specific DNA lesions in human skin that are often found at dipyrimidine sites. These photoproducts are likely to be biologically relevant regarding skin carcinogenesis, as p53 mutations in skin tumours are most often found at these UV radiation-specific sites within DNA. Psoriasis patients receiving long-term phototherapy are at an increased risk of non-melanoma skin cancers. OBJECTIVES: The aim of this study was to quantify DNA photoproducts in human epidermis in vivo following consecutive doses of UVB and to investigate variations in DNA damage according to skin type, UVB dose and age. METHODS: Eleven psoriasis patients receiving UVB phototherapy three times a week were recruited and underwent skin biopsies on a non-sun-exposed site before starting phototherapy and after three, nine and 18 UVB exposures. A biopsy was also taken at least 4 weeks after stopping phototherapy. DNA was extracted from separated epidermis and three types of photoproducts were quantified using a novel 32P high-performance liquid chromatographic technique. RESULTS: The mean level of cyclobutane dipyrimidine dimers (CPDs) after three doses of UVB (dose range 0.03-0.15 J cm-2) was 3.2 (range 0.8-8.9) photoproducts per 106 normal nucleotides for TT=T dimers and 4.5 (range 0-14) per 106 normal nucleotides for TT=C dimers. The mean levels of TT-C 6-4 photoproducts after three doses of UVB were very low (0.2, range 0-1.8). Overall, the levels of TT=T and TT=C reached a plateau at three exposures and were found to decrease for subsequent exposures despite increasing UVB doses. Skin type was negatively associated with mean levels of CPDs. However, significant differences in levels of photoproducts were seen between individuals, even after adjusting for skin type. No association was found between challenge dose of UVB and photoproduct yield in this study. CONCLUSIONS: This study showed a great individual variation in the accumulation of DNA photoproducts following exposure to repetitive doses of UVB. Photoadaptive responses of human skin involving DNA repair, tanning and epidermal thickening are likely to explain the overall lack of increase in DNA lesions throughout phototherapy. This in vivo study confirms that psoriasis patients produce a significant amount of DNA photolesions at suberythemal doses of UVB. Further work is needed to investigate which host factors are most likely to predict susceptibility to UV radiation-induced DNA damage.

Adult↗
PubMedDate not supplied

[The clinico-pathogenetic validation of intravascular laser therapy in the combined treatment of salmonellosis in young infants].

The clinico-laboratory study of the effectiveness of the intravascular ultraviolet laser therapy (IUVLT) in the complex treatment of 25 young children with prolonged severe salmonellosis was made. The study revealed that under the action of IUVLT the main symptoms of salmonellosis (intoxication and diarrhea) disappeared at a shorter period than after treatment by traditional methods. The pathogenetic basis of the effectiveness of IUVLT was the induction of the enzymes of the monooxygenase system of the liver and an increase in the activity of the enzymes of antiradical protection.

Acute Disease↗
PubMedDate not supplied

[Ultraviolet irradiation of blood and peloid therapy (standard- and short-course) of patients with chronic bronchitis].

Clinical symptoms, clinico-biochemical picture, immunograms and external respiration function were studied in 43 patients with chronic bronchitis undergoing UV blood radiation and peloid therapy. This treatment had a corrective effect on chronic bronchitis pathogenesis. Short courses of photon-peloid therapy showed the same effectiveness as routine ones at lower risk of side effects and higher cost efficiency.

Adult↗
PubMed2005

ATX-S10(Na)-photodynamic therapy is less carcinogenic for mouse skin compared with ultraviolet B irradiation.

BACKGROUND: Photodynamic therapy (PDT) is available for the treatment of various skin tumours and other skin diseases. Ultraviolet (UV) irradiation induces DNA damage, cyclobutane pyrimidine dimers (CPD) (6-4) photoproducts (6-4PP) and 8-hydroxy-2'-deoxyguanosine (8-OHdG), all of which are carcinogenic for the skin. However, effects of PDT on DNA damage and carcinogenesis are unclear. OBJECTIVES: To compare the production of photoproducts and the induction of skin tumours in mouse epidermis treated with UVB or PDT. METHODS: We performed UVB irradiation or ATX-S10(Na)-PDT on the skin of 20 hairless mice, in each case, and analysed DNA damage and tumour induction. RESULTS: After a single irradiation of UVB on mouse skin, CPD, 6-4PP and 8-OHdG were detected in the nuclei of keratinocytes. In contrast, PDT-treated mouse keratinocytes showed induction of 8-OHdG, but not of CPD or 6-4PP. Skin tumours induced by UVB irradiation (3 kJ m(-2) three times weekly) were observed following 15 weeks of irradiation (mean +/- SEM tumour incidence 3.2 +/- 1.8%; tumour number 3.2 +/- 1.6 per mouse) and increased depending on irradiation times and doses. Following 30 weeks of UVB irradiation (3 kJ m(-2) three times weekly), mean +/- SEM tumour incidence and tumour number were 28.7 +/- 4.8% and 14.2 +/- 2.8% per mouse, respectively. Although skin tumours were also detected in PDT-treated mouse skin following 80 weeks of treatment (mean +/- SEM tumour incidence 9.1 +/- 1.8%; tumour number 12.2 +/- 2.3 per mouse), the number of tumours was not statistically different from untreated mouse skin (mean +/- SEM tumour incidence 4.1 +/- 3.8%; tumour number 5.2 +/- 3.3 per mouse). CONCLUSIONS: PDT induced 8-OHDG but not CPD or 6-4PP, and was shown to be a relatively safe modality following multiple applications to mouse skin.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed2006

Management of psoriatic arthritis: the therapeutic interface between rheumatology and dermatology.

Psoriatic arthritis is an inflammatory arthritis, which occurs in up to 30% of individuals with psoriasis. Dermatologists and other physicians treating psoriasis are in an ideal position to screen for the condition, and with rheumatologists, strategize optimal therapy. Mild skin and joint manifestations may be treated effectively with topical agents, ultraviolet light therapy, and nonsteroidal anti-inflammatory drugs. More severe manifestations of the disease, including progressive peripheral joint damage, spine disease, enthesitis, dactylitis, and severe skin changes, require systemic therapy. Traditional systemic agents include methotrexate, sulfasalazine, and cyclosporine. When these agents are not adequate or not tolerated, new biologic agents, particularly anti-tumor necrosis factor (TNF) compounds, have shown significant and enduring benefit in all disease domains, improvement in quality of life and function, and inhibition of progressive joint damage.

Antirheumatic Agents↗
PubMed1981

Lentigo maligna melanoma in a treated psoriatic plaque.

Lentigo maligna melanoma developed in a patient with a 41-year history of psoriasis. The patient had received substantial radiation therapy and limited tar and ultraviolet energy therapy to the site at which melanoma developed. We raise the question of whether the carcinogenic modalities used to treat the patient may have influenced the development of melanoma.

Female↗
PubMed1997

[Psoriasis today].

PATHOGENESIS: Psoriasis is a proliferative disease of the epiderm which leads to major disorders in keratinocyte differentiation. The pathogenesis remains largely unknown. It has been hypothesized that intrinsic alterations of the keratinocyte or local or general immune disorders could be involved. GENES IMPLICATED: Psoriasis is a genodermatosis which is revealed or aggravated by environmental factors. The nature and chromosomal localization of the genes involved is currently under study. LOCAL TREATMENT: Over the last years, use of vitamin D has largely replaced former topical corticosteroid therapy. Phototherapy using narrow spectrum ultraviolet B is currently the standard treatment for extensive psoriasis. GENERAL TREATMENT: Methotrexate, retinoids and cyclosporin are effective in severe psoriasis but have side effects which limit their indications.

Dermatologic Agents↗
PubMed1986

Effects of ultraviolet radiation and immunosuppressive therapy on mouse epidermal cell kinetics.

The effects of immunosuppressive drugs on epidermal cell mitotic activity and the proliferative response of epidermis following ultraviolet radiation (UVR) were tested. Hairless (Skh-hr 1) mice were treated with immunosuppressive drugs at equivalent clinical doses with or without concomitant UVR (290-400 nm). Epidermal parameters measured were mitotic index (Im), rate of entry into mitosis (Fm), flash labelling index (FLI), rate of entry into DNA synthesis (Fs) and DNA content (flow cytometric analysis). In non-irradiated skin, prednisolone therapy depressed both mitotic activity and DNA synthesis; azathioprine and cyclosporin A had no effect; cyclophosphamide therapy increased the Fm and FLI values. Following repeated doses of UVR, there were enhanced mitotic activity and DNA synthesis in epidermis. Prednisolone therapy moderately depressed both proliferative responses; cyclophosphamide enhanced mitotic activity; azathioprine and cyclosporin A had no effect on these responses. The significance of these findings in relation to potential for increased susceptibility of skin to UV-induced carcinogenesis is discussed.

Animals↗