Skin lesions in anti-Pm-Scl-70 positive systemic sclerosis-dermatomyositis overlap syndrome improve during local PUVA phototherapy

Mohanna, M. T.; Distler, Oliver; Sprott, Haiko; Kündig, Thomas M.; French, Lars E.; Hofbauer, Günther F.L.

doi:10.1684/ejd.2013.2136

Cited by 6 publications

(7 citation statements)

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“…Phototherapy for patients with SSc is being actively investigated (Table ); all studies used UVA wavelength for treatment of skin sclerosis in patients with SSc because UVA can penetrate into the deep dermis better than UVB, and maybe the concern over UVB‐induced photosensitivity in connective tissue disease. Most studies comprised of case reports, case series, and uncontrolled trials support the hypothesis that PUVA therapy improves clinical outcomes in terms of (i) skin sclerosis, (ii) joint mobility, (iii) histology, (iv) serology, and (v) immunohistochemistry . Not only topical PUVA but also bath and oral PUVA reduced skin thickness .…”

Section: Phototherapy In Systemic Sclerosismentioning

confidence: 97%

“…This study supported the hypothesis that UVA wavelength has an antifibrotic effect via inhibition of collagen synthesis and induction of collagenase production. One case report of SSc‐dermatomyositis overlap demonstrated that bath PUVA combined with 150 mg sildenafil once daily reduced all fingertip necrosis and significantly improved sensation in both hands . This seems to be that PUVA phototherapy can be used with other treatments and add the benefit of the treatment in terms of skin sclerosis and/or blood circulation.…”

Section: Phototherapy In Systemic Sclerosismentioning

confidence: 99%

“…Several studies have demonstrated that phototherapy reduces skin sclerosis . The advantage of phototherapy is that it provides a locally direct effect on the skin without internal organ involvement, so there are no systemic complications and quality of life is improved.…”

Section: Introductionmentioning

confidence: 99%

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Phototherapy in systemic sclerosis: Review

Chaowattanapanit

Choonhakarn

Foocharoen

et al. 2017

Photoderm Photoimm Photomed

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Systemic scleroderma-also known as systemic sclerosis (SSc)-is a chronic systemic connective tissue disease characterized by collagen deposition in cutaneous and internal organs, leading to skin sclerosis and multiple organ fibrosis. The pathogenesis is complex and remains poorly understood. Treatment is based on organ involvement and requires a multidisciplinary approach. Skin sclerosis can cause disability, leading to decreasing quality of life. Various systemic antifibrotic therapies have been used; however, most have unsatisfactory results. Recently, phototherapy and in particular ultraviolet A (UVA) has been used to treat skin sclerosis in SSc patients with satisfactory results. The main mechanisms include lymphocyte apoptosis, cytokine alteration, inhibition of collagen synthesis and increased collagenase production, and neovascularization, leading to the breakdown of collagen fibrils resulting in skin softening or even healing digital ulcers. Most studies reported that psoralen plus UVA (PUVA) and UVA1 phototherapy improved clinical outcomes vis-à-vis skin sclerosis, joint mobility, ulcers, and histopathology. PUVA and UVA1 phototherapy therefore have potential as an alternative or adjunctive therapy for patients with SSc.

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Section: Phototherapy In Systemic Sclerosismentioning

confidence: 97%

Section: Phototherapy In Systemic Sclerosismentioning

confidence: 99%

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Phototherapy in systemic sclerosis: Review

Chaowattanapanit

Choonhakarn

Foocharoen

et al. 2017

Photoderm Photoimm Photomed

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“…Treatments were given once a week167.3Unavailable107Significant softening of the affected areas, and normalization of skin temperatureNoMorita et al [93]Case report58/MSystemic sclerosisPUVA topical0.10 J/cm 2 3 times a week, increasing to a maximum single dose of 8 J/cm 2 272.329 weeksUnavailableDecreased necrosis in fingers, reduced symptoms of swelling, erosions, crusting, and induration in fingers. Follow-up at 5 months showed slight swelling of both hands without new fingertip lesionsSildenafil 150 mg dailyMohanna et al [94]Case report65/FGeneralized morpheaPUVA0.4 J/cm 2 3 times a weekUnavailable8 weeks24Hand closure and skin sclerosis index. Score went from three to one.…”

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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“…Az IIM-ákban jelentkező antitesteket két nagy csoportra lehet osztani. A myositisasszociált autoantitestek (MAA) -antipolymyositis-scleroderma (PM-Scl), anti-Ku, anti-U1, -U2, -U3 ribonukleoprotein (RNP), anti-SSA/Ro, anti-SSB/La -elsősorban azokban a betegekben mutathatók ki, akik overlap myositisben szenvednek, tehát myositisük más kötőszöveti betegséggel is társul [3,4,5,6,7,8,9]. A myositisspecifi kus autoantitesteket (MSA) kizárólag myositisben találjuk meg, a sejtek citoplazmájában vagy sejtmagjában található specifi kus fehérjék ellen irányulnak.…”

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