Narrow-band ultraviolet B (NBUVB) phototherapy has recently been reported to be an effective and safe treatment modality for vitiligo. In the present report, we evaluated the efficacy and safety of NBUVB therapy for vitiligo in Chinese patients. Seventy-two vitiligo patients treated from 2000 to 2003, were included retrospectively (male: female=33:39, mean age: 38.5). Among them, 61 were non-segmental type and 11 the segmental type. Treatments were given two to three times a week for a maximum period of one year with an initial dose of 0.2 J/cm2 and a 0-20% increment each session (mean accumulation dose: 155.3 J/cm2). Computer image analysis by Supervise classification was used to estimate the area of vitiligo involvement before and after treatment. An excellent response (75-100% area of repigmentation) was obtained in 9 patients (12.5%) and a good response (50-75%) in 24 (33.3%), a moderate response (25-50%) in 20 (27.8%), and a poor response (0-25%) in 19 (26.4%). In summary, 45.8% of our patients had more than 50% repigmentation. Burns were a side effect in 5 patients (7%) and transient erythema with itching or xerosis was noted in 5 patients (7%). These results indicate that NBUVB phototherapy is an effective and safe treatment choice for generalized vitiligo.
No studies have been performed evaluating skin barrier alterations in humans exposed to ultra-low humidity (ULH) in spite of several lines of evidence from animal experiments suggesting that the skin barrier is altered on exposure to ULH. The objectives of this study were to assess barrier function changes in workers occupationally exposed to ULH (relative humidity 1.5%), and to evaluate whether the exposure duration shows a dose-response relationship with transepidermal water loss (TEWL) and skin capacitance. A total of 49 male workers exposed to ULH for 12 h per working day were classified into five subgroups based on their ULH exposure duration (<0.5 months, 0.5-1.0 month, 1.1-10.0 months, 10.1-20.0 months, and >20.0 months). A group of 12 age-matched male laboratory workers from a normal humidity environment were recruited as a control group. TEWL and skin capacitance were measured to evaluate their skin barrier function. TEWL measurements showed a significant decline (8.3+/-0.4 vs 10.0+/-0.4 g m(-2) h(-1), P < 0.05) but no differences were found in skin capacitance (39.7+/-1.3 a.u. vs 45.0+/-2.4 a.u., P = 0.68) between the whole ULH exposure group and the control group. Maximum decreases in TEWL and skin capacitance were seen in the subgroups exposed for <0.5 months and 0.5-1.0 month, respectively. Almost completely natural recovery occurred in skin capacitance after 20 months ULH exposure, in contrast to less than 90% recovery in TEWL. Three stages were defined according to the pattern of alterations in TEWL and skin capacitance in relation to ULH exposure duration. A positive association between TEWL and skin capacitance occurred in the control group and stage I but a negative correlation in stage II. No correlation was found in stage III. Our study demonstrated that workers exposed to a ULH environment could exhibit skin barrier alterations. Both TEWL and skin capacitance decreased within 2 weeks of ULH exposure. The maximum alterations in TEWL and skin capacitance occurred during 0.5-1.0 months and 2 weeks, respectively. TEWL recovered partially and more slowly than skin capacitance which recovered earlier and almost completely.
Simultaneous exposure to carbon disulfide and noise may have a combined effect on hearing impairment. In this study we investigated hearing loss in 131 men with exposure to noise [80-91 A-weighted decibels; dB(A)] and CS 2 (1.6-20.1 ppm) in a viscose rayon plant. These men were compared with 105 men in the adhesive tape and electronic industries who were exposed to noise only and with 110 men employed in the administrative office of the rayon plant who were exposed to low noise and no CS 2 . We conducted interviews to obtain sociodemographic information and exposure assessments, and we performed physical examinations, including hearing tests. Results showed that the prevalence of hearing loss of > 25 dB hearing loss (dBHL) in rayon workers (67.9%) was much higher than that in administrative workers (23.6%) and in the adhesive tape and electronic industrial workers (32.4%). Hearing loss occurred mainly for speech frequencies of 0.5, 1, and 2 kHz. When the CS 2 exposure was measured by the product of CS 2 exposure level and employment years, the adjusted odds ratios of hearing loss of > 25 dBHL in rayon workers, compared with administrative workers, were 3.8 [95% confidence interval (CI), 1.5-9.4] for those with the exposure of 37-214 year-ppm, 14.2 (95% CI, 4.4-45.9) with 215-453 year-ppm exposure, and 70.3 (95% CI, 8.7-569.7) with exposure of > 453 year-ppm. The study suggests that CS 2 exposure enhances human hearing loss in a noisy environment and mainly affects hearing in lower frequencies.
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