Medium-dose UVA1 phototherapy in localized scleroderma and its effect in CD34-positive dendritic cells.
Camacho NR, Sánchez JE, Martin RF, González JR, Sánchez JL.Department of Dermatology, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico 00936-5067

BACKGROUND: UVA1 radiation seems to be effective in morphea. CD34+ dendritic cells are significantly decreased in lesional skin of morphea patients.

OBJECTIVE: We evaluated the therapeutic effectiveness of medium-dose UVA1 phototherapy in localized scleroderma and its effect in the number of dermal CD34+ dendritic cells in skin biopsy specimens of these patients.

METHOD: Patients were irradiated with UVA1 (30 J/cm(2)) 30 times. Dermal CD34+ dendritic cells were counted before and after therapy.

RESULTS: There was clinical improvement after UVA1 irradiation. Dermal CD34+ dendritic cells significantly increased after UVA1 irradiation.

CONCLUSION: Medium-dose UVA1 therapy is effective in the treatment of localized morphea. Effectiveness is associated with an increase in the number of CD34+ dendritic cells in the dermis.

PUBMED Link: http://www.ncbi.nlm.nih.gov/pubmed/11606918

BACKGROUND: Graft versus host disease is one of the obstacles to successful bone marrow transplantation. It often affects the skin. Phototherapy has been used because of its strong local immunomodulatory activity and it is an option for adjuvant therapy for skin lesions of graft versus host disease resistant to conventional therapy.

OBJECTIVE: To make a descriptive analysis of treating graft versus host disease with phototherapy (PUVA or narrowband UVB). Methods – Nine patients with cutaneous manifestation of acute or chronic graft versus host disease were studied. The first choice therapy was PUVA, applied in six patients, and three were treated with narrowband UVB. The sessions were held three times a week and therapeutic response was evaluated after 12 sessions.

RESULTS: All patients with acute graft versus host disease showed improvement, with the disappearance of erythema and edema. In those with chronic graft versus host disease, there was good response to therapy with regression of lichenoid lesions and better mobility of patients with the sclerodermoid form. Two patients had severe progression and died.

CONCLUSION: Phototherapy showed to be effective in treating skin manifestations of acute and chronic graft versus host disease. PUVA allows control of the disease. The narrowband UVB is an option for patients who cannot take systemic medications.