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PubMed1977

Effect of ultraviolet light therapy, given over a period of several weeks, on the amount and composition of the skin surface lipids.

Ultraviolet (UV) light therapy was given over a period of several weeks to 19 test persons on one side of the back. The duration of the treatment was gradually increased from 30 sec to 7 min. After conclusion of the treatment quantitative lipid determination was made on both the treated and the untreated sides of the back, using the direct extraction method and the paper absorption method. The lipids obtained in this way were analysed by thin-layer chromatography. The following were the most important results: (1) The amount of skin surface lipids was significantly increased by UV irradiation. This results goth from an increase in the epidermal lipids as well as in the lipids of the sebaceous blands. (2) The percentage of free cholesterol in the skin surface lipids was significantly increased by UV irradiation. This increase is probably connected with a thickening of the stratum corneum. (3) The percentage of free fatty acids in the skin surface lipids is significantly increased by UV therapy. This shows that the living conditions of the saprophyte skin flora, which set free lipases, are improved as a result of this treatment or that this treatment leads to an increase of the activity of the bacterial lipases in the excretory ducts of the sebaceous glands.

Adult↗
PubMed2002

Guidelines for dosimetry and calibration in ultraviolet radiation therapy: a report of a British Photodermatology Group workshop.

This report examines the dosimetry of ultraviolet (UV) radiation applied to dermatological treatments, and considers the definition of the radiation quantities and their measurement. Guidelines are offered for preferred measurement techniques and standard methods of dosimetry. The recommendations have been graded according to the American Joint Committee on Cancer classification of strength of recommendation and quality of evidence (summarized in Appendix 5).

Humans↗
PubMed1981

A phototherapy cabinet for ultraviolet radiation therapy.

A newly designed cabinet can be used for the treatment of psoriasis with fluorescent ultraviolet (UV) lamps. the new design provides more uniform distribution of UV radiation in both the horizontal and vertical axes, and several safety features have been added. The distribution and uniformity of UV output in this and in a previously described cabinet are compared. The UV output at the vertical center of the older UV light cabinet was six times greater than that at either the top or bottom, while the design of the present cabinet provides uniform UV radiation except for a slight increase at head height and at the level of the lower legs compared with the middle third of the cabinet. The variation in output of the older cabinet may, in part, explain the commonly encountered difficulty in the phototherapy of psoriasis of the scalp and lower extremities.

Phototherapy↗
PubMed2006

Selenium supplementation, soluble tumor necrosis factor-alpha receptor type 1, and C-reactive protein during psoriasis therapy with narrowband ultraviolet B.

OBJECTIVE: We examined the influence of supplementation with selenomethionine on soluble tumor necrosis factor-alpha receptor type 1 (sTNF-R1) and C-reactive protein (CRP) concentrations in patients with psoriasis who were treated with narrowband ultraviolet B. METHODS: Thirty-seven patients had narrowband ultraviolet B therapy five times a week and received 200 mug of selenium daily as selenomethionine (group 1, n = 19) or placebo (group 2, n = 18) for 4 wk. Assessment, performed at baseline, after 2 and 4 wk, and 4 wk after the end of treatment included measurement of the Psoriasis Area and Severity Index (PASI) and serum concentrations of selenium (micrograms per liter), sTNF-R1 (nanograms per milliliter), and CRP (milligrams per liter). Control sera were obtained from 20 healthy volunteers. RESULTS: Baseline PASI was 12.70 +/- 5.48 (13.02 +/- 6.25 in group 1 and 12.37 +/- 4.71 in group 2), selenium concentration was 50.55 +/- 9.54 (49.05 +/- 10.38 and 52.13 +/- 8.61, respectively), sTNF-R1 concentration was 1.91 +/- 0.38 (1.96 +/- 0.37 and 1.87 +/- 0.40, respectively), and CRP concentration was 25.34 +/- 8.27 (26.12 +/- 8.42 and 24.57 +/- 7.72). In controls, selenium concentration was 48.71 +/- 9.39 (P > 0.05 versus patients), sTNF-R1 concentration was 1.48 +/- 0.30 (P < 0.05), CRP concentration was <6. The baseline sTNF-R1 level correlated to PASI value (r = 0.40, P < 0.05) and CRP concentration (r = 0.36, P > 0.05). The treatment resulted in an almost parallel decrease in PASI in both groups. At 4 wk after the end of treatment, selenium concentrations were 83.77 +/- 5.13 in group 1 and 52.12 +/- 7.54 in group 2 (P < 0.05), sTNF-R1 concentrations were 1.72 +/- 0.27 and 1.47 +/- 0.26 (P < 0.05), and CRP concentrations were 7.72 +/- 4.23 and 8.15 +/- 3.32, respectively (P > 0.05). Selenium concentration correlated inversely with CRP in group 1. CONCLUSION: The results confirm that sTNF-R1 and CRP concentrations are increated in active psoriasis and that supplementation with selenomethionine for 4 wk in safe doses is ineffacious as adjuvant therapy in patients with psoriasis.

Administration, Oral↗
PubMed1986

Status of ultraviolet A dosimetry in methoxsalen plus ultraviolet A therapy.

The carcinogenic risk of methoxsalen plus ultraviolet A treatment (PUVA) is almost certainly related to the cumulative UVA exposure dose. A reliable estimate of UVA dose is a major component, therefore, in determining the long-term safety of this treatment modality. Thirty-one UVA meters from twenty-nine different PUVA treatment centers were compared with a calibrated UVA meter. The results inferred that 95% of UVA meters used in PUVA centers are reading between 57% and 159% of the true UVA irradiance, a factor of 2.8 in relative sensitivity. This wide variation in accuracy between the UVA meters gives cause for concern. These variations were attributed to differences in calibration procedure, optical properties of the sensors, and, most importantly, poor quality control by the manufacturers. The situation that appears to have existed since the introduction of PUVA therapy can be improved only if dermatologists agree that the present inaccurate and uncertain approach to UVA measurements is unsatisfactory. Manufacturers of UVA meters should be encouraged to provide instruments as reliable as the dosimeters used in radiotherapy, in which the prescribed dose is probably within 5% of the true value. Ideally, a standard type of UVA meter with appropriate physical properties and an agreed calibration procedure should be used by all centers engaged in PUVA treatment.

Humans↗
PubMed2005

Protective effect of epigallocatechin gallate and esculetin on oxidative DNA damage induced by psoralen plus ultraviolet-A therapy.

We examined antioxidants exhibiting no effects on DNA cross-linking, which is the basis of psoralen and ultraviolet-A therapy for skin diseases, and suppressing oxidative DNA damage incidental to the therapy. Epigallocatechin gallate and esculetin effectively suppressed oxidative DNA damage with little effect on the formation of DNA cross-linking. These antioxidants might be useful in suppressing the adverse reaction induced by this therapy.

Catechin↗
PubMed2000

Bath psoralen-ultraviolet A therapy in atopic eczema.

AIMS: To evaluate the efficacy of bath psoralen-ultraviolet A (PUVA) therapy in severe cases of atopic dermatitis (AD) in adults using the extended Six Area, Six Sign Atopic Dermatitis (SASSAD) score. METHODS: Thirty-five adult subjects with severe AD underwent bath PUVA therapy for a maximum of 30 sessions ranging from one to three times a week. The only other treatment allowed during the study was topical application of hydrocortisone. RESULTS: There were a total of six drop-outs, three due to aggravation of symptoms. After the maximum 30 sessions the remaining 29 subjects showed 82.1% improvement in the severity of lesions, 75.2% reduction in extension of lesions, 74% improvement in itching and 79% improvement in night-time rest. Patient evaluations gave an overall score of 8.8 on a scale of 0-10.

Adolescent↗
PubMed1985

Ultraviolet light therapy in chronic urticaria.

Fifteen patients with chronic urticaria were treated with ultraviolet light B (UVB) for 1-3 months during the spring 1984 and a follow-up study was performed in November 1984-January 1985. Patients with cold urticaria, cholinergic urticaria and dermographism became clearly better or got rid of their symptoms more often than those with "non-specific" chronic urticaria. The good results achieved during the phototherapy held during the summer but in the autumn urticaria became worse in one third of the cases. The result suggests that UV-therapy might be worth trying in many patients with chronic urticaria.

Adolescent↗
PubMed2002

Medium-dose ultraviolet A1 therapy for pityriasis lichenoides et varioliformis acuta and pityriasis lichenoides chronica.

BACKGROUND: Ultraviolet A1 (340-400 nm) was found to be effective in the treatment of cutaneous T-cell-mediated diseases. OBJECTIVE: The purpose of the present study was to assess the efficacy of UVA1 phototherapy for pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis lichenoides chronica (PLC). METHODS: Eight patients (3 with PLEVA and 5 with PLC) received 60 J/cm(2) UVA1 daily until remission. Four patients also had lesions inaccessible to UVA1 that were used as control lesions. Immunocytologic studies of skin infiltrates and circulating T cells were done. RESULTS: Six patients showed complete clinical and histologic recovery. Two patients with PLC had a partial improvement. Unirradiated control lesions never improved. Serious short-term adverse effects were not encountered. No effects on circulating lymphocytes were reported. CONCLUSION: UVA1 therapy is an effective and well-tolerated treatment for PLEVA and PLC. The therapeutic activity seems to be related to direct effects on cutaneous inflammatory infiltrates because the lesions in nonexposed cutaneous areas did not respond.

Adult↗
PubMed1998

Therapeutic photoimmunology: photoimmunological mechanisms in photo(chemo)therapy.

Ultraviolet radiation, either alone or in combination with photosensitizing agents, is widely used for the treatment of skin diseases. The efficacy of photo- and photochemotherapeutic modalities is thought to result, at least in part, from the induction of immunomodulatory effects. In particular, UV radiation has been shown to affect (i) the production of soluble mediators, (ii) the expression of cell-surface receptors and (iii) to induce apoptosis in pathogenetically relevant cells. UVB radiation-induced immunomodulatory effects are limited to the epidermis, whereas UVA radiation affects both epidermal and dermal cell populations. UVB and UVA radiation can exert essentially identical immunomodulatory effects, which result, however, from different photobiological mechanisms.

Animals↗
PubMed1998

Topical psoralen-ultraviolet A therapy for palmoplantar dermatoses: experience with 35 consecutive patients.

OBJECTIVE: To report the effectiveness of topical psoralen-ultraviolet A (PUVA) therapy for palmoplantar dermatoses and to describe our method of administration of this treatment modality. DESIGN: We conducted a retrospective study of 35 patients, 27 to 66 years of age, who received topical hand and foot PUVA therapy. MATERIAL AND METHODS: Ten patients had psoriasis vulgaris, 8 had pustular psoriasis, 5 had dyshidrotic eczema, and 12 had other types of dermatitis. The affected area was soaked in a psoralen solution, 0.0005% methoxsalen (10 mg of methoxsalen in 2 L of warm water), for 30 minutes and then exposed to incremental amounts of ultraviolet A light three times weekly until the dermatosis subsided or cleared. Treatment frequency was then reduced and ultimately discontinued. Time to maximal improvement of the hands and feet was defined as the period from the beginning of PUVA treatment to the point at which the frequency of treatment was reduced from three times weekly to twice weekly. RESULTS: Fourteen patients (40%) had clearing of their disease, and 14 others (40%) had improvement of their conditions. The mean time to clearing was 2.8 months (range, 2 weeks to 7 months), and the mean number of treatments was 27.3 (range, 10 to 55). The mean total dose of ultraviolet A received was 140 J/cm2 (range, 9 to 530). Two patients (6%) had no response to treatment. Mild localized ultraviolet-related erythema developed in 16 patients (46%). Five patients "dropped out" of treatment, and nine other patients discontinued treatment during maintenance therapy. The principal reason cited was inconvenience. CONCLUSION: Topical PUVA therapy is an effective and safe treatment option for recalcitrant dermatoses affecting the palms and soles.

Adult↗
PubMed2006

Efficacy of 8-methoxypsoralen vs. 5-methoxypsoralen plus ultraviolet A therapy in patients with mycosis fungoides.

BACKGROUND: Psoralen plus ultraviolet (UV) A (PUVA) is the standard treatment for early stage mycosis fungoides (MF). When 8-methoxypsoralen (8-MOP) is used in PUVA therapy, it often produces intolerance reactions such as nausea, vomiting and headache. OBJECTIVES: To investigate whether 5-methoxypsoralen (5-MOP) is a safe and effective alternative to 8-MOP in PUVA therapy for MF. METHODS: A retrospective database search and chart review was done to identify patients with MF who received PUVA with either 5-MOP or 8-MOP as initial monotherapy at our institution. Between 1990 and 2004, 14 patients [seven men and seven women; mean age 70 years, range 51-82; National Cancer Institute disease stages IA (n = 6) and IB (n = 8)] received 5-MOP, and 24 patients [21 men and three women; mean age 58 years, range 28-89; disease stages IA (n = 11), IB (n = 12) and IIB (n = 1)] received 8-MOP. RESULTS: Twelve of 14 patients (86%) in the 5-MOP group and 22 of 24 (92%) in the 8-MOP group had a complete response to PUVA. These two subgroups of complete responders did not differ significantly in terms of PUVA therapy duration, number of treatments or cumulative UVA dose. They also did not differ significantly in terms of relapse-free rate [8% (one of 12) vs. 23% (five of 22)] or time to relapse [17 months (range 4-31) vs. 14 months (range 4-33)]. Moreover, PUVA maintenance therapy with either 5-MOP or 8-MOP in a subset of patients [26% (nine of 34)] did not affect long-term relapse-free status either. CONCLUSIONS: 5-MOP and 8-MOP have comparable therapeutic efficacy when used in PUVA therapy for MF.

5-Methoxypsoralen↗