British Association of Dermatologists and British Photodermatology Group guidelines for the safe and effective use of psoralen–ultraviolet A therapy 2015

Ling, Tsui C.; Clayton, Timothy; Crawley, Jane; Exton, L.S.; Goulden, V.; Ibbotson, S.H.; McKenna, Kevin E.; Mustapa, M.F. Mohd; Rhodes, Lesley; Sarkany, R.; Dawe, Robert S.; McHenry, P.; Hughes, Jenny; Griffiths, Mary; McDonagh, A.J.G.; Buckley, D.A.; Nasr, I.; Swale, V. J.; Williamson, C.E. Duarte; Levell, N. J.; Leslie, Tabi A.; Mallon, E.; Wakelin, S. H.; Hunasehally, P.; Cork, Michael J.; Ungureanu, Sergiu; Donnelly, J.; Towers, Kurt; Saunders, Clare; Davis, R.; Brain, Amanda

doi:10.1111/bjd.14317

Cited by 90 publications

(141 citation statements)

References 364 publications

(817 reference statements)

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“…Dar bant UVB, erken evre hastalıkta, sadece yama lezyonlar varsa tercih edilmelidir. Plak lezyonlar, folikülotropik hastalık, dar bant UVB'ye yetersiz yanıt veya dar bant UVB sonrası hızlı relaps gibi durumlarda tercih edilecek fototerapi yöntemi PUVA olmalıdır (35,44,45). MF'si olan çocuk hastalarda, plak lezyonlar yoksa, öncelikli tercih edilecek fototerapi yöntemi dar bant UVB'dir, hipopigmente yamalar UVB'ye çok iyi yanıt vermektedir (46,47) (Resim 2).…”

Section: Mikozis Fungoideste Fototerapiunclassified

“…Buna karşılık, İngiliz Fotodermatoloji Grubu'nun 2015 PUVA rehberinde, MF'de, hızlı rekürrens gösteren hastalıkta relapsı önlemek için idame PUVA yapılabileceği, bu yönde herhangi bir kanıt olmaksızın, uzman görüşü olarak önerilmektedir. İdame protokolü ve süresi konusunda bir yorum yapılmamaktadır (44). MF ve Sezary sendromunda fototerapiyle ilgili 2016 Amerika rehberinde, ilk fototerapi sonrası nüks olan hastaların sonraki fototerapilere de iyi yanıt verdikleri, idame fototerapinin uzun dönem sağkalım üzerine herhangi bir etkisi olmadığı gibi önemli noktalar belirtilmekle birlikte, dar bant UVB için 16-32 aylık, PUVA için ise 24-48 aylık, giderek azalan sıklıkta bir idame önerilmektedir.…”

Section: Mikozis Fungoideste Fototerapiunclassified

“…Oral beksaroten ile dar bant UVB kombinasyonunun etkili olduğuna dair sadece az sayıda olgu bildirisi mevcuttur (51,52). PUVA, erken evre hastalıkta monoterapi ile yetersiz yanıt olması, monoterapi ile tam düzelme sonrası hızlı nükste remisyon süresini uzatma gereksinimi doğması, folikülotropik hastalık veya ileri evre hastalık varlığı gibi durumlarda, asitretin, isotretinoin, beksaroten, interferon, ekstrakorporeal fotoferez ve lokal radyoterapi gibi MF tedavisinde kullanılan diğer yöntemlerle kombine edilebilmektedir (34,35,44,53,54). PUVA ve asitretin kombinasyonu, uzun süre PUVA uygulanacak hastalarda deri kanseri gelişimi riskini azaltma açısından oldukça avantajlı olabilir.…”

Section: Mikozis Fungoideste Fototerapiunclassified

“…Bu çalışmada, yanıt oranları, yanıt için gerekli seans sayısı ve remisyon süresi açısından PUVA daha üstün bulunmakla birlikte, aslında, psoriasiste dar bant UVB'nin optimal tedavi sıklığı haftada üçtür. Haftada üç seans dar bant UVB ile haftada iki seans PUVA'yı karşılaştıran çalışmaların büyük kısmında her iki tedavi yönteminin eşit etkinlikte olduğu saptanmıştır (44,103). Bu nedenle de, psoriasiste birinci basamak fototerapi yöntemi dar bant UVB olup, PUVA'nın birinci basamağa geçebileceği durumlar, yaygın ve kalın plak psoriasis ve dar bant UVB'ye yetersiz yanıttır (44).…”

Section: Psoriasiste Fototerapiunclassified

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Current Approach to Phototherapy Applications in Dermatology Practice: Part 2. Phototherapy in Vitiligo, Mycosis Fungoides, Atopic Dermatitis, Sclerosing Diseases and Psoriasis

Gençosmanoğlu¹

2017

tdd

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Section: Mikozis Fungoideste Fototerapiunclassified

Section: Psoriasiste Fototerapiunclassified

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Current Approach to Phototherapy Applications in Dermatology Practice: Part 2. Phototherapy in Vitiligo, Mycosis Fungoides, Atopic Dermatitis, Sclerosing Diseases and Psoriasis

Gençosmanoğlu¹

2017

tdd

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“…In these cases, the psoralen is administered topically or systemically followed by local or whole body UVA illumination. Treatment modalities are diverse and may differ by psoralen derivative and/or by doses of UVA light (6). Furthermore, PUVA is under clinical investigation for the treatment of multiple other diseases mostly involving uncontrolled cell proliferation (7).…”

mentioning

confidence: 99%

Psoralen and Ultraviolet A Light Treatment Directly Affects Phosphatidylinositol 3-Kinase Signal Transduction by Altering Plasma Membrane Packing

Aelst¹,

Devloo²,

Zachée

et al. 2016

Journal of Biological Chemistry

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Edited by George CarmanPsoralen and ultraviolet A light (PUVA) are used to kill pathogens in blood products and as a treatment of aberrant cell proliferation in dermatitis, cutaneous T-cell lymphoma, and graftversus-host disease. DNA damage is well described, but the direct effects of PUVA on cell signal transduction are poorly understood. Because platelets are anucleate and contain archetypal signal transduction machinery, they are ideally suited to address this. Lipidomics on platelet membrane extracts showed that psoralen forms adducts with unsaturated carbon bonds of fatty acyls in all major phospholipid classes after PUVA.

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Comparison of Narrowband UV-B With Psoralen–UV-A Phototherapy for Patients With Early-Stage Mycosis Fungoides

et al. 2019

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IMPORTANCE Phototherapy is one of the mainstays of treatment for early mycosis fungoides (MF). The most common modalities are psoralen-UV-A (PUVA) and narrowband UV-B (NBUVB). OBJECTIVE To compare the efficacy and adverse effects of PUVA vs NBUVB in early-stage MF. DATA SOURCES A systematic review was performed by searching Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Ovid Medline, PubMed, Cochrane Library, American College of Physicians ACP Journal Club, and Database of Abstracts of Review of Effectiveness from inception to March 30, 2018. UV A, PUVA, mycosis fungoides, Sézary syndrome, cutaneous T-cell lymphoma, UV B, and UVB were used as either key words or MeSH terms. STUDY SELECTION Studies of cohorts with histologically confirmed early-stage MF, defined as stages IA, IB, and IIA, that compared PUVA vs NBUVB, had at least 10 patients in each comparator group, and reported outcomes of response to therapy. Exclusion criteria were studies with patients with stage IIB or higher MF, pediatric patients, fewer than 10 in each comparator group, noncomparative studies, case reports, and abstract studies. DATA EXTRACTION AND SYNTHESIS The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed. Data were pooled using a random-effects model with odds ratio (OR) as effect size. MAIN OUTCOMES AND MEASURES Main outcomes were complete response rate, partial response rate, disease recurrence, and adverse effects, including erythema, nausea, pruritus, phototoxic effects, dyspepsia, and pain. RESULTS Seven studies were included with a total of 778 patients (405 of 724 [55.9%] men; mean age, 52 years); 527 were treated with PUVA and 251 with NBUVB. Most of the included studies were of poor to moderate quality. Any response was found in 479 of the 527 (90.9%) patients treated with PUVA vs 220 of 251 (87.6%) treated with NBUVB (OR, 1.40; 95% CI, 0.84-2.34; P = .20). Complete response was found in 389 of 527 (73.8%) patients who received PUVA vs 156 of 251 (62.2%) who received NBUVB, which was statistically significant (OR, 1.68; 95% CI, 1.02-2.76; P = .04). Partial response was similar (90 of 501 [18.0%] vs 64 of 233 [27.5%]; OR, 0.58; 95% CI, 0.33-1.04; P = .07). No significant difference was found between PUVA and NBUVB in terms of adverse effects of erythema (38 of 527 [7.2%] vs 17 of 251 [6.7%]; P = .54), nausea (10 of 527 [1.9%] vs 3 of 251 [1.2%]; P = .72), pruritus (2 of 527 [0.4%] vs 4 of 251 [1.7%]; P = .26), phototoxic effects (7 of 527 [1.4%] vs 2 of 251 [0.9%]; P = .72), dyspepsia (6 of 527 [1.2%] vs 0 of 251 [0%]; P = .59), or pain (0 of 527 [0%] vs 2 of 251 [0.9%]; P = .50). CONCLUSIONS AND RELEVANCE The findings suggest that PUVA is a potential alternative to NBUVB in the management of early-stage MF. These findings have implications for clinicians involved in the management of early-stage MF.

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British Association of Dermatologists and British Photodermatology Group guidelines for the safe and effective use of psoralen–ultraviolet A therapy 2015

Cited by 90 publications

References 364 publications

Current Approach to Phototherapy Applications in Dermatology Practice: Part 2. Phototherapy in Vitiligo, Mycosis Fungoides, Atopic Dermatitis, Sclerosing Diseases and Psoriasis

Current Approach to Phototherapy Applications in Dermatology Practice: Part 2. Phototherapy in Vitiligo, Mycosis Fungoides, Atopic Dermatitis, Sclerosing Diseases and Psoriasis

Psoralen and Ultraviolet A Light Treatment Directly Affects Phosphatidylinositol 3-Kinase Signal Transduction by Altering Plasma Membrane Packing

Comparison of Narrowband UV-B With Psoralen–UV-A Phototherapy for Patients With Early-Stage Mycosis Fungoides

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