The World of UV Phototherapy by Chris Cane » CTCL Cutaneous T-Cell Lymphoma

Narrowband UVB Phototherapy in New Zealand

Chris Cane — Sat, 03 Jul 2010 13:05:11 +0000

I was wandering around the internet today looking for what’s new in UVB and I came across a posting by DermNet NZ. I thought that some of you would find it interesting.

They report, Compared with broadband UVB:

Exposure times are shorter but of higher intensity.
The course of treatment is shorter.
It is more likely to clear the skin condition.
Longer periods of remission occur before it reappears.

They also mention that “This range of UV radiation has proved to be the most beneficial component of natural sunlight for psoriasis. Narrowband UVB may also be used in the treatment of many other skin conditions including atopic eczema, vitiligo, pruritus, lichen planus, polymorphous light eruption, early cutaneous T-cell lymphoma and dermographism.”

The original can be found at http://dermnetnz.org/procedures/narrowband-uvb.html - Enjoy!

Share and Enjoy:

UVB NB vs PUVA Treatment for Mycosis Fungoides.

Chris Cane — Sun, 31 Jan 2010 05:01:23 +0000

The full article publication is entitled “Efficacy of narrowband UVB vs. PUVA in patients with early-stage mycosis fungoides.” prepared by Ponte P, Serrão V, Apetato M. at the Department of Dermatology, Hospital dos Capuchos, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.

Abstract:

Introduction Mycosis fungoides (MF) is a non-Hodgkin’s T-cell lymphoma of the skin that often begins as limited patches and plaques with slow progression to systemic involvement. Narrowband ultraviolet (UV) B therapy has been proven to be an effective short-term treatment modality for clearing patch-stage MF. The effect of psoralen plus long-wave ultraviolet A (PUVA) in the treatment of patch- and plaque-type MF has also been thoroughly documented. Objectives The purpose of this study was to compare the efficacy and safety of narrowband UVB and PUVA in patients with early-stage MF. Methods We analysed the response to treatment, relapse-free survival and irradiation dose in 114 patients with histologically confirmed early-stage MF (stage IA, IB and IIA). Results A total of 95 patients were treated with PUVA (83.3%) and 19 with narrowband UVB (16.7%). With PUVA, 59 patients (62.1%) had a complete response (CR), 24 (25.3%) had a partial response (PR) and 12 (12.6%) had a failed response. Narrowband UVB led to CR in 12 (68.4%) patients, PR in 5 (26.3%) patients and a failed response in 1 (5.3%) patient.

There were no differences in terms of time to relapse between patients treated with PUVA and those treated with narrowband UVB (11.5 vs. 14.0 months respectively; P = 0.816). No major adverse reactions were attributed to the treatment. Conclusions Our results confirm that phototherapy is a safe, effective and well-tolerated, first-line therapy in patients with early-stage cutaneous T-cell lymphoma, with prolonged disease-free remissions being achieved.

It suggests that narrowband UVB is at least as effective as PUVA for treatment of early-stage MF.

Share and Enjoy:

UVA1 Phototherapy – Is it effective?

Chris Cane — Tue, 26 Jan 2010 05:01:16 +0000

The article concludes “Besides topical and systemic therapy, UVA1 radiation is a good option of treatment in various skin diseases. It is one of the first-line treatments for several sclerotic diseases and it often improves pruritus considerably.”

I came across this study during an internet search when a customer called me about the use of UVA1. I have to admit I was surprise by the fact that the use of UVA1 has shown some good results with atopic eczema, scleroderma and other challenges.

The authors say

“Good therapeutic effects of UVA1 therapy were shown in patients with atopic eczema, scleroderma, lichen sclerosus et atrophicus, keratosis lichenoides chronica, prurigo nodularis and with cutaneous T-cell lymphoma. Positive effects in some patients were seen in the urticaria pigmentosa and granuloma annulare group, no change to slight improvement was seen in most of the patients with rare, sclerosing skin diseases and no effect was seen in the chronic urticaria group.”

The study is titled “Efficacy of UVA1 phototherapy in 230 patients with various skin diseases” and is written by S. Rombold, K. Lobisch, K. Katzer, T. C. Grazziotin, J. Ring & B. Eberlein of the Department of Dermatology and Allergy Biederstein, Technical University of Munich, Munich, Germany.

To see the entire article << CLICK HERE FOR PDF >>

UVA1 id long wavelength UV in the 340 nm to 400 nm range. UVA1 therapy has been available since the early eighties in Europe and we’re slowly catching up here in the USA. UVA1 phototherapy can be effective in the treatment of inflammatory skin diseases such as exacerbated atopic eczema, localized scleroderma and granuloma annulare.

To see the entire article << CLICK HERE FOR PDF >>

Share and Enjoy:

Ultraviolet UVA-1 Phototherapy (UK Study)

Chris Cane — Mon, 16 Nov 2009 20:57:29 +0000

An older study (2003) highlights UVA-1 (340-400 nm) Ultraviolet Therapy.

The original work was completed by Dawe RS. at the: Photobiology Unit, Department of Dermatology, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK. r.s.dawe@dundee.ac.uk

Long-wavelength ultraviolet A (340-400 nm; UVA1) therapy is currently available in only a few dermatology departments. Equipment capable of delivering this waveband has been available since 1981, but it is only over the past decade that increasing numbers of studies assessing the potential of this as a therapy have been published. High-dose UVA1, which requires expensive and space-occupying apparatus, is effective as a monotherapy for acute flares of atopic dermatitis, but it has not yet been formally assessed as an adjunct, rather than as an alternative to conventional therapies including potent and very potent topical corticosteroids. Low-dose (which can be administered using a standard phototherapy cubicle fitted with appropriate lamps) and medium-dose UVA1 may be less effective for this indication. Another condition for which UVA1 is effective, and is particularly promising because we have no reliably effective treatment already, is localized scleroderma. It also appears to be effective in systemic lupus erythematosus (although it is not yet clear when it is indicated, and its safety needs to be assessed in more patients) and in polymorphic light eruption (although there have been no studies suggesting that UVA1 will have any advantages over standard prophylactic phototherapies). Open studies and case series suggest that UVA1 may prove beneficial for various other diseases, including cutaneous T-cell lymphoma, lichen sclerosus, keloids, systemic sclerosis and hand dermatitis. In the centres where it is available, UVA1 has already proved a useful addition to the range of phototherapies previously available. However, much more research is needed to confirm its efficacy for many of its potential indications, and to determine when and how it should be used.

Original Article << Click Here >>

Share and Enjoy:

What’s treated with UVB Narrowband?

Chris Cane — Tue, 14 Apr 2009 10:07:48 +0000

This is a tough question as UVB Narrowband in some ways has become a panacea for many skin challenges. Here’s a partial list of diseases that I’m aware of where UVB Narrowband is one of the treatment options.

Alopecia
Atopic Dermatitis
CTCL (Cutaneous T-Cell Lymphoma)
Dermatitis
Eczema
Graft vs Host Disease (GVHD)
Lichen Planus
Mycosis Fungoides
Parapsoriasis
Pityriasis Lichenoides (PLEVA)
Pityriasis rosea
Pityriasis Rubra Pilaris
Prurigo Nodularis
Pruritus associated with Polycythaemia Vera
Psoriasis
Scleroderma
Sebhorrheic dermatitis
Vitiligo

Share and Enjoy:

Background: UVBNB phototherapy in Dermatology

Chris Cane — Mon, 13 Apr 2009 18:56:21 +0000

Link to entire article << Click Here >>

The first report of the use of ‘phototherapy’ in the treatment of skin disorders dates from 1400 BC from India when patients with vitiligo were given certain plant extracts (whose active ingredients included psoralens) and then exposed to the sun. The real interest in the use of ultraviolet (UV) irradiation in the treatment of various skin diseases started in the 19th century when Niels Finsen received the Nobel Prize (1903) for his therapeutic results with UV irradiation in lupus vulgaris, the only dermatologist ever to be awarded one. This marked the start of modern phototherapy. It was used in thermal stations for the treatment of tuberculosis, in the treatment of leg ulcers in wartime, and various other skin diseases. It was a very long journey from the use of plant extracts and sun exposure to treat vitiligo to the use of oral psoralens and total body UVA-irradiation cabins (PUVA) to treat various skin diseases. In a landmark development, in 1974 Parrish et al reported the useful role of high intensity UVA tubes in combination with oral psoralens in the treatment of psoriasis leading to what is now known as PUVA therapy.

The history of UVB phototherapy is not as old as the history of photochemotherapy. Wiskemann introduced irradiation cabin with broad band UVB tubes in 1978 for the treatment of psoriasis and uremic pruritus. However, broad band UVB phototherapy was less efficient for treating psoriasis than PUVA and so never achieved popularity. The breakthrough came after 1988 when narrow-band UVB (NB-UVB) phototherapy was introduced for the treatment of psoriasis by van Weelden et al and Green et al.

Link to entire article << Click Here >>

Excerpted from an article by: Sunil Dogra, Amrinder Jit Kanwar, Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education & Research, Chandigarh, India

Correspondence Address:
Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education & Research, Chandigarh – 160102, India
ajkanwar@sify.com

Share and Enjoy: