Epidermal photoprotection may extend beyond melanin production, involving several factors such as epidermal layer thickness, optical properties and chromophores. Such a role was perceived to be reactive to UV irradiation, and more efficient in those with higher SPTs.
Our results show that CIC may be involved in the pathogenesis of BD, especially in those clinical forms of the disease with erythema nodosum, neurologic manifestations, and ocular manifestations. Patients at the mild end of the BD spectrum do not show significant changes in CIC levels compared to healthy control subjects. We can, therefore, suggest that in BD CIC may be implicated more in the pathogenesis of some features than of others.
Oral acyclovir was given to 60 patients with herpes genitalis--20 experiencing a first attack and 40 with recurrent attacks. All patients were followed up for 1 year. Serial serum samples from the patients as well as from 20 controls were studied to determine the effect of therapy on the immune response to herpes simplex virus (HSV). No toxicity was observed, and very few patients had rather insignificant side effects (e.g., diarrhea). The frequency of recurrence (number of recurrences per year) of genital herpes in acyclovir-treated patients was found significantly lower than in controls. More frequent recurrences were observed in those who had high antibody titer in their early convalescent phase sera than in those without or with a low titer of such antibodies. The antibody titers were reduced in those who received acyclovir as compared with controls. The mean time to seroconversion was longer in the acyclovir-treated group than in controls. Oral acyclovir is thus effective and well tolerated in patients with herpes genitalis. Treatment with acyclovir also diminishes the humoral antibody response to HSV, but it does not prevent recurrence. The effects of acyclovir on the immune response to HSV are discussed.
BackgroundPruritus is one of the most common skin alterations associated with chronic renal disease (CRD). Narrow band ultraviolet B (NB-UVB) is considered an effective and safe treatment modality for those patients.
ObjectiveThe objective of this study was to evaluate the effect of NB-UVB on serum calcium (Ca) and phosphorus (P) as possible pruritogenic substances in uremic patients.
Patients and methodsIn 40 patients with CRD-related pruritus and receiving regular hemodialysis (group A) serum levels of Ca, P, and Ca-P product were determined. The results were compared with positive controls of another 40 patients with CRD without pruritus and receiving regular hemodialysis (group B). Group A, patients with pruritus, was treated with totalbody NB-UVB phototherapy 3 times/week for 6 weeks, with assessments of pruritus using a visual analog scale score before and after the end of the sessions and at monthly intervals for 3 months after completion of the sessions. Estimation of serum levels of Ca, P, and Ca-P product was carried out and compared with the levels before phototherapy.
ResultsSignificantly higher serum levels of both P and Ca-P product were present in patients with CRD-related pruritus in comparison with their matched controls without pruritus. Serum Ca level was not significantly different between the two groups. After 6 weeks of NB-UVB, there was a significant reduction in the pruritus score (Po0.01), which was associated with a significant decrease in the serum levels of P and Ca-P product. Whereas the mean serum Ca level of all patients did not show a statistically significant difference after NB-UVB therapy (P = 0.312), a significantly higher percentage of patients showed normalization of their Ca level after phototherapy (74.3 vs. 32.5%, P = 0.004). Conclusion NB-UVB is an effective and safe treatment option in alleviating pruritus associated with CRD, with a possible effect of normalizing serum levels of both Ca and P. This highlights the role of Ca and P as expected pruritogenic substances in the appearance of itch in CRD patients.
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