The World of UV Phototherapy by Chris Cane » Site Default

Morphea – Some Background Information

Chris Cane — Fri, 26 Feb 2010 18:56:34 +0000

Author: Jennifer V Nguyen, MD, Resident Physician, Department of Dermatology, Hospital of the University of Pennsylvania

Coauthor(s): Victoria P Werth, MD, Professor of Dermatology and Medicine, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, Philadelphia Veterans Affairs Medical Center; Nicole Fett, MD, Clinical Educator, Department of Dermatology, University of Pennsylvania School of Medicine

Introduction:

Morphea, also known as localized scleroderma, is a disorder characterized by excessive collagen deposition leading to thickening of the dermis, subcutaneous tissues, or both. Morphea is classified into plaque, generalized, linear, and deep subtypes according to the clinical presentation and depth of tissue involvement. Unlike systemic sclerosis, morphea lacks features such as sclerodactyly, Raynaud phenomenon, nailfold capillary changes, telangiectasias, or progressive internal organ involvement. Morphea can present with extracutaneous manifestations, including fever, lymphadenopathy, arthralgias, and central nervous system involvement, and laboratory abnormalities, including eosinophilia, polyclonal hypergammaglobulinemia, and positive antinuclear antibodies.1,2,3

Although rare, epidemiologic studies suggest 0.9-5.7% of patients with morphea progress to systemic scleroderma.2 The transition may be marked by the development of Raynaud phenomenon and nailfold capillary changes.

It would be silly and foolhardy of me to copy the entire article from the eMedicine website.

The article in its entirety can be found at http://emedicine.medscape.com/article/1065782-overview

This article links to http://emedicine.medscape.com/article/1065782-treatment

Amongst other treatments the article discusses:

UVA and UVA-1 Broadband UVA (320-400 nm, low-dose), long-wavelength UVA (UVA1; 340-400 nm, low- or medium-dose), and psoralen plus UVA (oral or bath) photochemotherapy have produced marked clinical improvement of morphea lesions in multiple case series and a randomized controlled trial. Because UVA1 wavelengths penetrate deeper into the dermis, this modality is particularly effective in the treatment of morphea. Low-, medium-, and high-dose UVA are all effective. Medium-dose UVA1 provides for better long-term results than low-dose UVA1 in morphea as shown by ultrasound assessment.26 Unfortunately, the availability of UVA1 is currently limited. Narrowband UVB therapy, although less potent owing to its limited dermal penetration, can also be beneficial. Regimens combining UV therapy with topical corticosteroids or calcipotriene may be superior to either method alone.42,43

To see the entire article on treatment at the eMedicine site, See http://emedicine.medscape.com/article/1065782-treatment

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Replacing FSX72T12/UVB/HO (7RA-072) with UVB Narrow Band TL01 Lamps

Chris Cane — Sun, 14 Feb 2010 05:00:32 +0000

Many people ask about replacing FSX72T12/UVB/HO (7RA-072) lamps in older National Biological Corporation Panosol II (UVB604) units. It’s a fairly easy job to do. We do supply instructions on how to install UVB NB TL100W/01 lamps in the older systems at time of shipment. All the customer need do is order lamps, provide us with the serial number of the UVB604 that the lamps will be installed in and we will ensure that the FDA records are updated to reflect hat the Panolsol II unit with that serial number has been upgraded to now use UVB Narrowband Lamps.

Best thing to do is email us (support@amjo.net) or give us a call 513-942-2770 and we can get the ball rolling for you.

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UVA/UVA1 phototherapy and PUVA photochemotherapy…

Chris Cane — Wed, 16 Sep 2009 21:00:39 +0000

UVA/UVA1 phototherapy and PUVA photochemotherapy in connective tissue diseases and related disorders: a research based review.

Breuckmann F, Gambichler T, Altmeyer P, Kreuter A.

Department of Dermatology, Ruhr-University Bochum, 44791 Bochum, Germany. Frank.Breuckmann@ruhr-uni-bochum.de.

BACKGROUND: Broad-band UVA, long-wave UVA1 and PUVA treatment have been described as an alternative/adjunct therapeutic option in a number of inflammatory and malignant skin diseases. Nevertheless, controlled studies investigating the efficacy of UVA irradiation in connective tissue diseases and related disorders are rare.

METHODS: Searching the PubMed database the current article systematically reviews established and innovative therapeutic approaches of broad-band UVA irradiation, UVA1 phototherapy and PUVA photochemotherapy in a variety of different connective tissue disorders.

RESULTS: Potential pathways include immunomodulation of inflammation, induction of collagenases and initiation of apoptosis. Even though holding the risk of carcinogenesis, photoaging or UV-induced exacerbation, UVA phototherapy seems to exhibit a tolerable risk/benefit ratio at least in systemic sclerosis, localized scleroderma, extragenital lichen sclerosus et atrophicus, sclerodermoid graft-versus-host disease, lupus erythematosus and a number of sclerotic rarities.

CONCLUSIONS: Based on the data retrieved from the literature, therapeutic UVA exposure seems to be effective in connective tissue diseases and related disorders. However, more controlled investigations are needed in order to establish a clear-cut catalogue of indications.

Original PubMed Link << Click Here >>

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Ray Boissy Receives Award

Chris Cane — Wed, 27 May 2009 12:08:40 +0000

A friend and colleague of mine received “the Achievement Award from the American Skin Association (ASA) for his work studying vitiligo and pigment cell biology.”

Ray Boissy chairs the National Vitiligo Foundation (www.nvfi.org) which is now based here in Cincinnati. The announcement was made yesterday in the University of Cincinnati’s Deans List publication.

The announcement reads:

See http://healthnews.uc.edu/publications/deanslist/?/8616/

Raymond Boissy, PhD, professor of dermatology and cell biology, has received a 2009 Achievement Award from the American Skin Association (ASA) for his work studying vitiligo and pigment cell biology. Boissy was recognized for his contributions to the scientific understanding of the skin disorder, which causes white patches on the skin due to pigment loss. He is currently studying the etiology and cell biology of the disease. Boissy received an award plaque at the Society for Investigative Dermatology meeting this month in Montreal. The achievement award is one of a series of ASA awards recognizing outstanding work that brings significant improvement in the treatment available to people suffering from specific skin disorders. Boissy, who also serves as the director of basic science research at the College of Medicine, has published over 100 scientific papers and 30 review articles and book chapters and has helped edit a book titled “The Pigmentary System: Physiology and Pathophysiology.” He is the past secretary/treasurer of the PanAmerican Society for Pigment Cell Research and is currently the chair of the National Vitiligo Foundation.

Congratulations to Ray Boissy!

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