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At least 811 records · Page 45Linked to original sources
PubMed1993

PUVA, UVB, psoriasis, and nonmelanoma skin cancer.

This article reviews the English-language literature on the risk of nonmelanoma skin cancer from phototherapy (UVB) or photochemotherapy (PUVA) in the treatment of psoriasis. The evolution of the debate on the carcinogenic potential of these treatment is discussed, particularly with reference to PUVA. Available data indicate that therapeutic UVB has a low risk of producing cutaneous cancers, with the possible exception of those on male genital skin. However, there is a definite cutaneous carcinogenic risk from oral PUVA. The major associated risk factors are reviewed. We provide recommendations for the assessment and treatment of patients to minimize this risk.

Dose-Response Relationship, Drug↗
PubMed1997

The impact of psoriasis on the quality of life of patients from the 16-center PUVA follow-up cohort.

BACKGROUND: The impact of psoriasis on the quality of life of patients is likely to be principally related to alterations in individual appearance and consequent psychosocial disability. Quantifying the impact of psoriasis and related changes from therapy would help in the selection of optimal management. OBJECTIVE: Our purpose was to evaluate the impact of psoriasis on patients with severe disease who have had photochemotherapy (PUVA). METHODS: In 1979 we interviewed 877 of 988 still participating patients who were enrolled in 15 of 16 centers in the PUVA Follow-up Study. We determined the impact of psoriasis on quality of life with a questionnaire that had been modified to incorporate measures of impairment that are likely to be affected by cutaneous disease. RESULTS: Psoriasis had substantial impact on the quality of life. Women were more likely than men to report impairment in quality of life dimensions. The impact of disease decreased with increasing age. Moderate to high relative impact on total quality of life was more often reported by patients who had recently used UVB phototherapy than by those using PUVA or methotrexate. CONCLUSION: Psoriasis has a substantial impact on the quality of life. This impact seems to decrease with increasing age. Use of specific treatments are also associated with the extent to which psoriasis affects quality of life.

Aged↗
PubMed1998

Narrow band UVB (311 nm) phototherapy and PUVA photochemotherapy: a combination.

BACKGROUND: Psoralen-UVA (PUVA) photochemotherapy is widely used for the treatment of psoriasis despite concerns of skin carcinogenesis from high cumulative UVA doses and number of treatments. OBJECTIVE: We attempted to determine whether combined bath-PUVA with narrow-band (311 nm) phototherapy improves efficacy and reduces long-term toxicity. METHODS: Twelve psoriatic patients underwent phototesting with 311 nm lamps and, after topical bath-water psoralen sensitization, with 311 nm, UVA, or both radiations. Patients were treated with bath-PUVA on one side of the body and with bath-PUVA plus 311 nm exposures (bath-PUVA-311 nm) on the other side. On both sides, four weekly treatments were delivered and UVA doses were increased once weekly whereas 311 nm doses were adjusted at each exposure. RESULTS: Psoralen sensitization did not modify the erythematous threshold to 311 nm radiation. However, 311 nm exposures enhanced the phototoxic activity of bath-PUVA. Bath-PUVA-311 nm cleared psoriasis with fewer exposures and lower cumulative UVA doses under the same minimally erythemogenic conditions. CONCLUSION: Combination with 311 nm exposures enhanced the phototoxic and therapeutic activities of bath-PUVA.

Administration, Cutaneous↗
PubMed1998

Management of localized scleroderma.

Localized scleroderma denotes a spectrum of conditions characterized by circumscribed fibrotic areas involving different levels of the dermis, subcutis, and sometimes underlying soft tissue and bone. Although the clinical course of the disease is often benign, widespread lesions and disabling joint contractures may lead to significant complications. The pathogenesis of the different types of localized scleroderma is still unknown. Numerous therapeutic agents have been reported to be effective in this disease spectrum, but controlled studies are rare. The purpose of this review is to summarize previous experience and to discuss recent advances in the management of localized scleroderma.

Clinical Trials as Topic↗
PubMed2001

Eosinophilic pustular folliculitis (Ofuji's disease): indomethacin as a first choice of treatment.

Eosinophilic pustular folliculitis (EPF) is characterized by erythematous patches of large follicular papules and pustules involving mainly the face. Although various treatments have been attempted for EPF, including systemic and topical steroid, diaphenylsulphone, colchicine, minocycline as well as UVB phototherapy, there is no consensus on the first choice of treatment. We report a typical case and summarize 25 patients with EPF treated in our hospital between 1978 and 1998. Indomethacin was most frequently used (12/25) and showed clinical improvement in the majority of the cases (11/12). The effect of indomethacin was usually observed within 1--2 weeks after initiation of treatment. Decrease of peripheral blood eosinophils accompanied the clinical improvement. Thus, indomethacin should be considered as a first choice of treatment for EPF.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1978

Controlled study of PUVA and adjunctive topical therapy in the management of psoriasis.

In a random study of 116 patients with psoriasis vulgaris, oral psoralen photochemotherapy (PUVA) used alone was compared to PUVA plus adjunctive topical therapy with tar, dithranol, or topical corticosteroids. PUVA plus topical corticosteroids produced more rapid clearing of psoriasis but despite maintenance therapy, the frequency of recurrences of the disease during the early phase of follow-up was significantly higher with that treatment, as compared to all other treatments. Dithranol plus PUVA also cleared psoriasis quicker than PUVA alone but patient acceptability for that regimen was low. The addition of tar to PUVA therapy appeared to have little influence on results.

Adult↗
PubMed1994

Localization of transforming growth factor-alpha RNA and protein in the skin of psoriatic patients receiving therapy.

Fourteen patients with chronic plaque psoriasis requiring in-patient therapy were treated with a variety of antipsoriatic agents. All had four skin biopsies taken: two prior to therapy, one from a psoriatic plaque and one from adjacent clinically normal skin, and two further biopsies, one 2-3 weeks after starting therapy, and one at clinical clearance, taken from an area where there was previously a psoriatic plaque. In addition, three biopsies were taken from clinically normal skin of non-psoriatics. Transforming growth factor-alpha (TGF-alpha) RNA and protein distributions were estimated in these biopsies, using in situ hybridization with a cRNA TGF-alpha probe, and an antibody to TGF-alpha polypeptide. Prior to therapy, grain counts showed elevated levels of TGF-alpha RNA in the subcorneal layers of the epidermis. These levels decreased during clearance of the psoriasis. In one patient whose plaques did not clear, there was no decrease of TGF-alpha mRNA. Antibody studies showed the presence of TGF-alpha polypeptide in the epidermis prior to therapy, with a relative concentration of immunoprotein in the upper epidermal layers, compared with a more uniform distribution of immunoprotein after treatment, and in uninvolved skin of the same psoriatic patient. These studies extend our knowledge of the relationship between TGF-alpha and psoriatic skin.

Anthralin↗
PubMed2005

Topical tazarotene: a review of its use in the treatment of plaque psoriasis.

Tazarotene (Tazorac) is a topical retinoid indicated for the treatment of plaque psoriasis. When used as monotherapy, topical tazarotene was effective at controlling signs and symptoms of plaque psoriasis, and had significantly lower post-treatment relapse rates than fluocinonide cream. The most common adverse events associated with tazarotene therapy are skin-associated events, such as pruritus, burning, and erythema. Combination therapy with tazarotene and mid-to-high potency topical corticosteroids generally resulted in a greater therapeutic effect than that with tazarotene alone, reduced the irritancy of tazarotene, and decreased the risk of post-treatment disease flare seen with corticosteroids; it also has the potential to reduce the degree of skin atrophy associated with topical corticosteroids. The combination of tazarotene and phototherapy also appears promising. Thus, tazarotene, as monotherapy or in combination with topical corticosteroids or UV light therapy, represents a useful treatment option in patients with plaque psoriasis.

Administration, Topical↗
PubMed1982

The effects of ultra-violet laser radiation on cancer.

A group of mice implanted with squamous cell carcinoma (CA1025) and melanoma (B16) were irradiated with a cw krypton laser using 3374A (total dosage 346 j/cm2, and 660 j/cm2), and 3507A (total dosage 367 j/cm2), and a pulse N2 laser 3371a (total dosage 471 j/cm2, 660 j/cm2, and 165 j/cm2). In all groups, tumorous mice were used as controls. Regression of tumors was observed at wavelengths of 3374A and 3371A (total dosage 471 j/cm2 and 660 j/cm2). No regression was observed at 3507A. The regression in some cases was very impressive. The preliminary work on N2 laser irradiation of basal cell carcinoma (in human beings) and of BEL 7404 liver carcinoma cells in vitro and irradiation of one patient with an N2 laser performed in China will also be reported.

Animals↗