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V Nikolaou, A Sachlas, E Papadavid, A Economidi, K Karambidou, L Marinos, A Stratigos, C Antoniou
BACKGROUND: Phototherapy is one of the main treatments for mycosis fungoides (MF). In this study, we analyzed the efficacy and safety of phototherapy as a first line treatment in patients with early stage disease. METHODS: We analyzed treatment outcomes in a group of 227 early stage patients. The chi-squared test, the parametric t-test and ANOVA test and the non-parametric tests of Mann-Whitney and Kruskal-Wallis were applied for data analysis. RESULTS: 55...
March 13, 2018: Photodermatology, Photoimmunology & Photomedicine
Jashin J Wu, Murali Sundaram, Martin Cloutier, Marjolaine Gauthier-Loiselle, Annie Guérin, Rakesh Singh, Arijit Ganguli
BACKGROUND: Psoriasis is a risk factor for cardiovascular events. OBJECTIVE: To assess the risk of major cardiovascular events and the effect of cumulative treatment exposure on cardiovascular event risk in psoriasis patients treated with tumor necrosis factor-alpha inhibitors (TNFis) versus phototherapy. METHODS: Adult psoriasis patients were selected from a large US administrative claims database (Q1:2000 - Q3:2014) and classified in two mutually exclusive cohorts, based on whether they were treated with TNFis or phototherapy...
February 27, 2018: Journal of the American Academy of Dermatology
Paul Jie Wen Tern, Julia Gass
Melanin in the nail bed in patients with skin type VI has been suggested to afford some protection against photo-onycholysis. We report a case of a 16-year-old male patient with skin type VI with onycholysis following PUVA treatment for hypopigmented mycosis fungoides. Symptoms resolved with the application of topical steroid.
February 2018: Clinical Case Reports
Nitesh Shirsath, Karin Wagner, Simone Roos, Michaela Schlederer, Christian Ringel, Lukas Kenner, Bernhard Brüne, Peter Wolf
The effects of 8-methoxypsoralen plus ultraviolet A (PUVA) and ultraviolet B (UVB) on imiquimod-induced psoriasis were examined in a mouse model. Mouse skin was treated with repetitive sub-phototoxic doses of PUVA or UVB before or during the induction of toll-like receptor 7/8 activation and psoriasis through the application of imiquimod. PUVA, to a greater degree than UVB, suppressed the established imiquimod-induced psoriatic phenotype, but pretreatment with PUVA prior to administration of imiquimod also reduced the susceptibility of murine skin to respond to imiquimod to a greater degree than did UVB...
February 13, 2018: Acta Dermato-venereologica
Emre Gazyakan, Christoph Hirche, Holger Engel, Ulrich Kneser, Amir K Bigdeli
OBJECTIVE: psoralen and ultraviolet A (PUVA) phototherapy (PT) has become a standard treatment for several severe skin diseases. Photosensitization is done by oral psoralen intake. In minor cases, PUVA can lead to skin changes like erythema and hyperpigmentation. However, it can also lead to severe burn injuries when exposed to extensive UV light. This makes the treatment in a burn center inevitable. METHODS: We report the clinical observation of a 38-year-old man presenting with an extensive burn injury caused by sun tanning after PUVA PT...
February 2, 2018: Annals of Plastic Surgery
I Vázquez-Osorio, S González-Delgado, C Suárez-García, P Gonzalvo-Rodríguez, E Rodríguez-Díaz
Blisters associated with PUVA treatments are an adverse effect of photochemotherapy that has been reported in the literature. Asymptomatic blisters appear spontaneously mainly on the lower limbs and resolve without treatment. The differential diagnoses to consider include a phototoxic reaction, pseudoporphyria, and PUVA-induced bullous pemphigoid. We describe the clinical and histologic features in 5 cases of blistering secondary to PUVA treatment. If this adverse effect is accurately diagnosed, photochemotherapy need not be interrupted, and unnecessary diagnostic procedures and additional treatments can be avoided...
February 1, 2018: Actas Dermo-sifiliográficas
Akimichi Morita
Phototherapy utilizes the beneficial effects of ultraviolet (UV) wavelengths to affect immunoregulatory functions. UV light phototherapy using narrowband UV-B (NB-UVB) and bath-psoralen UV-A (bath-PUVA) therapy are well-established treatments for psoriasis. Dual-action mechanisms of UV phototherapy have been identified: apoptosis and immune suppression. NB-UVB depletes pathogenic T cells by inducing apoptosis and regulatory T cells. Other wavelengths are also utilized for phototherapy, namely 308-nm excimer light and 312-nm flat-typed NB-UVB...
January 25, 2018: Journal of Dermatology
Sabrina Mai-Yi Fan, Po-Hua Chen, Yu-Ting Tseng, Jin-Bon Hong, Wannhsin Chen, Tsen-Fang Tsai, Sung-Jan Lin
Transplantation of autologous cultured melanocytes as cell suspension has been used for the treatment of vitiligo. The recipient site is often prepared by laser-mediated dermabrasion. Such procedures encounter disadvantages including prolonged transplantation duration, unsecured cell adherence to lesional skin and potential scarring. To improve this, here we propose a method by preparing recipient sites before transplantation by psoralen and ultraviolet A (PUVA)-induced sunburn followed by transplanting cells with a chitosan-based melanocyte spheroid patch...
January 10, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
D Brass, T Fouweather, D D Stocken, C Macdonald, J Wilkinson, J Lloyd, P M Farr, N J Reynolds, P J Hampton
BACKGROUND: Hand eczema is a common inflammatory dermatosis that causes significant patient morbidity. Symptoms such as pain, itch and localised swelling contribute to disruption of activities of daily living, lack of sleep, and missed days from work. The aetiology is often multifactorial. Previous studies comparing psoralen ultraviolet A (PUVA) and narrowband ultraviolet B (NBUVB) have been small, non-randomised and retrospective. OBJECTIVES: To conduct an observer blinded randomized controlled pilot study using validated scoring criteria to compare immersion PUVA with NBUVB for the treatment of chronic hand eczema unresponsive to topical steroids...
December 13, 2017: British Journal of Dermatology
Laila Siddique, Hadjh Ahrns, Elizabeth Seiverling
Telangiectasia macularis eruptiva perstans (TMEP) is a rare form of cutaneous mastocytosis. While most cutaneous mastocytoses occur in children and are asymptomatic, TMEP occurs predominantly in adults and is associated with systemic manifestations, requiring medical management. TMEP is typically characterised by scattered red-brown macules on the trunk and extremities, but must be differentiated from other telangiectatic conditions such as scleroderma, hereditary haemorrhagic telangiectasia and telangiectasias secondary to cirrhosis...
November 30, 2017: BMJ Case Reports
Mariah Giberson, Ahmed Mourad, Robert Gniadecki
BACKGROUND: Folliculotropic mycosis fungoides (FMF) is a distinct subtype of mycosis fungoides (MF) with unique clinicopathological features. The medical literature suggests that FMF has a more aggressive course and worse survival than classic MF. Previous studies do not use standardized treatment, and no studies have reported an association between treatment response and overall survival (OS). OBJECTIVE: To compare OS for MF, FMF, and Sézary syndrome (SS) patients...
November 24, 2017: Dermatology: International Journal for Clinical and Investigative Dermatology
Aditya Maitray, Pukhraj Rishi
Psoralen compounds such as methoxsalen are photosensitizer agents used in conjunction with ultraviolet A (UVA) radiation exposure as photochemotherapy (Psoralens and ultraviolet-A therapy [PUVA therapy]) for certain epidermal skin disorders such as psoriasis and vitiligo. Methoxsalen has been shown to be associated with premature cataract formation by forming adducts with lens proteins following oral administration and subsequent UVA exposure. Hence, the use of UV-filtering glasses is recommended during PUVA therapy sessions...
November 2017: Indian Journal of Ophthalmology
José María Ortiz-Salvador, Amparo Pérez-Ferriols
Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases. Currently management of AD includes avoidance of triggering factors, skin care aiming to compensate the skin barrier defects, anti-inflammatory therapy (mostly topical corticosteroids and topical calcineurin inhibitors). When these first-line approaches are unsuccessful, systemic treatment or phototherapy ought to be carried out as next line of defence. Current phototherapy modalities for AD include broadband UVB (290-320 nm), narrowband UVB (311-313 nm), UVA-1 therapy (340-400 nm), UVA therapy plus 8-methoxypsoralens (PUVA), 308 nm excimer laser (EL) and Full spectrum light (FSL)...
2017: Advances in Experimental Medicine and Biology
Torello M Lotti, Serena Gianfaldoni
The exposure to ultraviolet radiations and visible light, or phototherapy, is a well-known therapeutic tool available for the treatment of many dermatological disorders. The continuos medical and technological progresses, of the last 50 years, have involved the field of phototherapy, which evolved from UVA and PUVA in its various forms, to the development of narrowband UVB (NB-UVB) and NB-UVB micro-focused phototherapies. Further advances in technology have now permitted the introduction of a new device emitting UVA-1 radiations...
2017: Advances in Experimental Medicine and Biology
Marcella Guarrera
Polymorphous light eruption (PLE) is the commonest immuno-mediated photodermatosis. It occurs after solar or artificial UV-light exposure and affects only the sun-exposed areas with preference of the V-area of the chest, of arms and forearms, legs, upper part of the back, and rarely the face. The lesions are itching or burning, and vary morphologically from erythema to papules, vesico-papules and occasionally blisters, plaques, sometimes erythema multiforme-like, insect bite-like wheals and purpura. The clinical manifestations befall within a few hours to days from light exposure, last a few days, and subside in about a week without sequelae...
2017: Advances in Experimental Medicine and Biology
Jmpa van den Reek, Mmb Seyger, Ppm van Lümig, Rjb Driessen, Cjm Schalkwijk, Mam Berends, Pcm van de Kerkhof, Emgj de Jong
BACKGROUND: A considerable disease period often precedes initiation of a biologic in patients with psoriasis. Little is known about this important period in patients' lives. Evaluation of this 'journey' can reveal important insights and opportunities for physicians and health care decision makers. OBJECTIVES: (1) To describe patient and treatment characteristics until the start of biologic treatment in patients with severe psoriasis, (2) to assess shifts in early (2005-2009) versus established (2010-2015) biologics prescription periods, (3) to assess changes in hospital/day care admissions before vs...
November 9, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
V Grandi, P Fava, S Rupoli, S Alberti Violetti, L Canafoglia, P Quaglino, E Berti, N Pimpinelli
UV-based (PUVA and narrowband UVB) phototherapy is broadly and commonly used in the treatment of Cutaneous T-cell Lymphomas (CTCL), yet unfortunately, the evidence for the efficacy of these treatments is based only on case series or prospective but non-randomized studies. Therefore, no internationally approved guidelines exist and no standardization of schedules has been proposed. Recently, consensus guidelines have been published by the United States Cutaneous Lymphoma Consortium. The aim of this study was to review the biological and clinical evidences on PUVA and NB-UVB in CTCL and to critically evaluate acceptability and feasibility of these guidelines in the real-life setting from the perspective of the Cutaneous Lymphoma Task Force of the Italian Lymphoma Foundation (Fondazione Italiana Linfomi, FIL)...
November 4, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
Ping Zhang, Mei X Wu
Psoriasis is an autoimmune inflammatory skin disease. In the past several decades, phototherapy has been widely used to treat stable psoriatic lesions, including trunk, scalp, arms and legs, and partial nail psoriasis. A variety of light/lasers with different mechanisms of action have been developed for psoriasis including ultraviolet B (UVB), psoralen ultraviolet A (PUVA), pulsed dye laser (PDL), photodynamic therapy (PDT), intense pulsed light (IPL), light-emitting diodes (LED), and so on. Because light/laser each has specific therapeutic and adverse effects, it is important to adequately choose the sources and parameters in management of psoriasis with different pathogenic sites, severities, and duration of the disorder...
October 24, 2017: Lasers in Medical Science
Hanna Bonnekoh, Tatevik Ohanyan, Dido Lenze, Karoline Krause, Marcus Maurer, Torsten Zuberbier, Frank Siebenhaar
A 71-year old woman with systemic mastocytosis presented to our department with an apoplectic insult one year ago and a 100 pack year smoking history. Skin manifestation of mastocytosis had started at the age of 50 years accompanied by a substantial increase of serum tryptase since the age of 60. Bone marrow involvement was confirmed 16 years later. Therapy of mastocytosis included antihistamines, montelukast, sodium cromoglycate, and PUVA therapy, all with limited success. This article is protected by copyright...
October 21, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
Giorgia Martini, Simona Campus, Bernd Raffeiner, Gianluca Boscarol, Alessandra Meneghel, Francesco Zulian
Pansclerotic morphoea (PM) is a subtype of juvenile localised scleroderma characterised by severe course with generalised full-thickness skin involvement and possible growth and functional impairment. PM treatment comprises a combination of immunosuppressive agents such as corticosteroids, methotrexate, mycophenolate mofetil, PUVA and antithymocyte globulin and biological agents used in off-label. A possible role of IL-6 in the regulation of firoblast differentiation and stimulation of collagen synthesis has been suggested and in patients with systemic sclerosis (SSc) the treatment with tocilizumab (TCZ) was associated to improvement of skin thickness and joint motion...
September 2017: Clinical and Experimental Rheumatology
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