Low-dose UVA1 phototherapy for treatment of localized scleroderma☆,☆☆,★
Section snippets
Patients
Twenty patients with severe LS were included in the study after informed consent was obtained. In all patients (11 female and 9 male; age 10 to 73 years) the diagnosis of LS was established according to clinical and histopathologic criteria. Patients were classified into three subgroups: (1) those with circumscribed plaques (n = 10), (2) those with linear morphea (n = 8), and (3) those with subcutaneous morphea (n = 2) (Fig. 1, A and B, Table I).
Equipment
The UVA1 irradiation equipment consisted of a high-intensity UVA1 cabin (Sellamed, Dr. Sellmeier, Ennepetal, Germany) emitting exclusively wavelengths in the 340 to 400 nm range. The irradiance at body distance was approximately 70 mW/cm2 for UVA.
Treatment
In all patients total body UVA1 phototherapy (340 to 400 nm) was administered four times a week for 6 weeks and once a week for another 6 weeks resulting in a total of 30 treatment sessions. Each treatment session consisted of an exposure of 20 J/cm2
RESULTS
The therapy was well accepted and completed by all patients. All patients had 30 treatments with doses of 20 J/cm2 at each treatment session resulting in a cumulative UVA1 dose of 600 J/cm2. During and after phototherapy, no side effects such as erythema, blistering, or pruritus were observed.
According to clinical and ultrasound criteria, more than 80% of the sclerotic lesions disappeared or markedly improved during UVA1irradiation in 18 of the 20 patients within less than 3 months (Table I).
DISCUSSION
Our results demonstrate that long-standing and severe LS can be markedly improved or cleared by low-dose UVA1 phototherapy. Different types of photochemotherapy have been suggested for sclerosing skin diseases, such as photopheresis, PUVA bath photochemotherapy, and oral PUVA therapy.8, 11, 13 Photopheresis has mainly been studied in patients with systemic sclerosis and has led to different results.11, 14 PUVA bath photochemotherapy, in which patients are immersed in an 8-MOP dilute bath water
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Cited by (0)
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From the Departments of Dermatology, Ruhr-University Bochum, a Ludwig-Maximilians University Munich,b and Heinrich-Heine University Düsseldorf.c
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Reprint requests: Martina Kerscher, MD, Department of Dermatology, Ruhr-University Bochum, Gudrunstrasse 56, D-44791 Bochum, Germany.
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