Efficacy of Ultraviolet A1 Phototherapy in Recalcitrant Skin Diseases

Suh, Kee Suck; Kang, Jin Seuk; Baek, Jae Woo; Kim, Tae Kwon; Lee, Jin Woo; Jeon, Young Seung; Jang, Min Soo

doi:10.5021/ad.2010.22.1.1

Cited by 25 publications

(23 citation statements)

References 32 publications

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“…Relapses were reported within 3 months in one-third of patients [16] , after 6 months in a patient treated with high-dose UVA1 (100 J/cm 2 ), or after 30 months in a patient treated with medium-dose UVA1 (65 J/cm 2 ) [23] . Also, CRs with no relapses up to 49.3 months after treatment were observed in patients treated with low-dose UVA1 (20 J/cm 2 ) [20] . Combined, these data provide convincing evidence for the duration of remission maintained by the UVA1 therapy.…”

Section: Discussionmentioning

confidence: 87%

“…The treatment regimens in-cluded daily phototherapy treatments 5 times per week which used fixed regimens similar to ours or were continued until clinical and/or histological clearance [14][15][16][17][18][19][20][21][22][23][24][25][26] . The rates of CR varied from 60 to 100% in studies of 4 to 19 patients [16,17,[19][20][21][22][23]26] and from no response to complete healing in case reports [14,15,18,24,25] . Forty years after the first use of PUVA in MF [27] , several heterogeneous studies with differences in patient selection, treatment protocols, and outcome variables have established the efficacy of PUVA and narrowband UVB in the treatment of MF [3] .…”

Section: Discussionmentioning

confidence: 99%

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Ultraviolet A1 Phototherapy in the Treatment of Early Mycosis Fungoides

et al. 2017

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Background: Phototherapy has been the mainstay of therapies for early mycosis fungoides (MF). The beneficial role of ultraviolet (UV) light on MF is suggested by the observation that lesions occur on non-sun-exposed areas. Therapeutic light sources that are available today are broadband UVB, psoralen and UVA, narrowband UVB, and long-wave UV (UVA1). Current literature provides increasing evidence on the use of UVA1 to treat MF. Aim: To investigate the treatment responses of early MF patients treated with fixed 30 J/cm² doses of UVA1 phototherapy. Material and Methods: Nineteen patients with early MF, stage IA-IIA of the TNM staging system, received fixed 30 J/cm² doses of UVA1, given 5 times weekly over 5 weeks. Therapeutic effectiveness was assessed by clinical examination and was confirmed by histological evaluation. Results: Of the 19 patients, complete responses were achieved in 12 (63%) and partial responses were achieved in 7 (37%) patients after UVA1 radiation exposures. During the study, UVA1 therapy was well tolerated. During the follow-up, 7 (58%) of the 12 patients with complete response relapsed within 3 months of the UVA1 therapy. Conclusion: The current study provides clinical and histological evidence for the effectiveness of UVA1 (30 J/cm² 5 times a week for 5 weeks) as a skin-directed therapy in the treatment of early MF; however, such a treatment failed to maintain a long and sustained response. Thus, studies to identify the optimal dosing protocol regarding the therapeutic efficacy, the factors affecting relapse time/rate, and the necessity of maintenance treatment are needed.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Ultraviolet A1 Phototherapy in the Treatment of Early Mycosis Fungoides

et al. 2017

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“…Moreover, cell damage was positively correlated with the radiation dose. UVA1 induces apoptosis of fibroblasts by reactive oxygen species (ROS), in which singlet oxygen is the most important member[17]-[20]. It has been demonstrated that low-dose (20 J/cm 2 ) UVA1 irradiation could inhibit fibroblast proliferation in a dose-dependent manner[21].…”

Section: Discussionmentioning

confidence: 99%

UVA1 irradiation inhibits fibroblast proliferation and alleviates pathological changes of scleroderma in a mouse model

Mei

Chen

Chang

et al. 2012

Journal of Biomedical Research

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The purpose of the present study was to compare the effects of different doses of ultraviolet radiation A1 (UVA1) on human fibroblast proliferation and collagen level in a mouse model of scleroderma, so as to identify appropriate irradiation doses for clinical treatment of scleroderma. Monolayer from human fibroblasts was cultured in vitro, and a mouse model of scleroderma was established by subcutaneous injection of 100 µL of 400 µg/mL bleomycin into the back of BALB/c mice for 4 weeks. The mouse models and human fibroblasts were divided into UVA1-exposed (100, 60 and 20 J/cm2) and UVA-unexposed groups. At 0, 24 and 48 h after exposure, cell proliferation and levels of hydroxyproline and collagen were detected. UVA1 irradiation was performed 3 times weekly for 10 weeks, and the pathological changes of skin tissues, skin thickness and collagen level were observed after phototherapy. Cell proliferation and the levels of hydroxyproline and collagen were inhibited after phototherapy, and there was a significant difference between the UVA1-exposed cells and UVA1-unexposed cells (P < 0.001). In addition, UVA1 phototherapy improved dermal sclerosis and softened the skin, and there were significant differences between the high-dose UVA1 group and the model group, and the negative group (P < 0.05). It is concluded that UVA1 radiation can reduce cell proliferation, and decrease hydroxyproline and collagen levels in a dose-dependent manner in vitro. High-dose UVA1 phototherapy has marked therapeutic effect on scleroderma in the mouse model. Decreased collagen level may be related to the reduced number and activity of cells, as well as inhibition of collagen synthesis.

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“…A 14-patient study showed a 70-J/cm 2 dose was more effective in treating localized scleroderma lesions than a 20 J/cm 2 dose [45]. In six patients with localized scleroderma treated two to three times a week, three patients experienced complete remission [50]. Two of the three received high-dose 100 J UVA1 therapy, of which one of them received 67 treatments and relapsed after 6 months, compared to one patient which received low-dose UVA1 twice weekly for 6 weeks for a total of 39 irradiations and did not relapse after 84-month follow up [50].…”

Section: Clinical Evidence Of Phototherapy’s Efficacymentioning

confidence: 99%

“…In six patients with localized scleroderma treated two to three times a week, three patients experienced complete remission [50]. Two of the three received high-dose 100 J UVA1 therapy, of which one of them received 67 treatments and relapsed after 6 months, compared to one patient which received low-dose UVA1 twice weekly for 6 weeks for a total of 39 irradiations and did not relapse after 84-month follow up [50]. A broadband UVA trial examined 63 patients with morphea and 15 patients treated with UVA1 5, 10, or 20 J/cm 2 with cumulative doses of 100, 200, and 400 J/cm 2 , respectively [51].…”

Section: Clinical Evidence Of Phototherapy’s Efficacymentioning

confidence: 99%

Phototherapy in Scleroderma

Hassani

Feldman

2016

Dermatol Ther (Heidelb)

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Systemic and localized scleroderma are difficult to manage diseases with no accepted gold standard of therapy to date. Phototherapeutic modalities for scleroderma show promise. A PubMed search of information on phototherapy for scleroderma was conducted. The information was classified into effects on pathogenesis and clinical outcomes. Studies on photopheresis were excluded. There were no randomized, double-blind, placebo-controlled studies, and only three controlled studies. The vast majority of identified studies evaluated ultraviolet A1 (UVA1) phototherapy. More rigorous studies are needed to evaluate phototherapy in the treatment of scleroderma. Based on the limited studies available, 20–50 J/cm2 of UVA1 therapy 3–4 times a week for 30 treatments is recommended.

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Efficacy of Ultraviolet A1 Phototherapy in Recalcitrant Skin Diseases

Cited by 25 publications

References 32 publications

Ultraviolet A1 Phototherapy in the Treatment of Early Mycosis Fungoides

Ultraviolet A1 Phototherapy in the Treatment of Early Mycosis Fungoides

UVA1 irradiation inhibits fibroblast proliferation and alleviates pathological changes of scleroderma in a mouse model

Phototherapy in Scleroderma

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