The impact of therapeutic modalities on patients with atopic dermatitis, psoriasis and vitiligo treated with phototherapy in the Jagiellonian University Outpatient Clinic.

Phototherapy involves repeated exposure of the skin to ultraviolet light and is commonly used in various dermatological diseases such as: psoriasis, atopic dermatitis and vitiligo. It constitutes a highly preferable treatment modality due to acceptable benefit/risk ratio. AIM: The aim of the study is to characterize parameters such as: number of PUVA or NB-UVB sessions, cumulative doses of phototherapy, values of minimal erythema doses (MED), periods of the year during phototherapy sessions in patients with vitiligo, atopic dermatitis and psoriasis attending the Jagiellonian University Outpatient Clinic. MATERIALS AND METHODS: This was a retrospective study of 50 Caucasian patients who attended the Department of Dermatology of the Jagiellonian University Outpatient Clinic over a period of one and a half years (from November 2016 to May 2018). RESULTS: We report that PUVA-therapy is more effective in achieving complete remission (CR) of skin lesions in patients with atopic dermatitis and vitiligo, compared to NB-UVB irradiations. In all patients enrolled to the study, apart from psoriatic patients treated with NB-UVB, the cumulative doses of UVA+P/NB-UVB were significantly higher during autumn/winter time than spring/summer time. Patients with vitiligo required higher cumulative doses and they needed more phototherapy sessions regardless the method of phototherapy in order to achieve CR, compared to other patients. The patients with psoriasis required, statistically significant, faster NB-UVB dose enhancement in order to maintain the efficacy of treatment than those with other diseases. CONCLUSIONS: Phototherapy constitutes an efficient, safe and accessible (in Poland and many other countries) method of therapy but there is still much to be discovered about the factors that affect its efficacy. Finding out more data relating to this issue could enable more effective treatment planning for particular patients and it would have an important economic impact.

Mice with mutations in Mahogunin ring finger-1 (Mgrn1) exhibit abnormal patterning of the left-right axis.

Mahogunin Ring Finger 1 (Mgrn1) encodes a RING-containing protein with ubiquitin ligase activity that has been implicated in pigment-type switching. In addition to having dark fur, mice lacking MGRN1 develop adult-onset spongy degeneration of the central nervous system and have reduced embryonic viability. Observation of complete situs inversus in a small proportion of adult Mgrn1 mutant mice suggested that embryonic lethality resulted from congenital heart defects due to defective establishment and/or maintenance of the left-right (LR) axis. Here we report that Mgrn1 is expressed in a pattern consistent with a role in LR patterning during early development and that many Mgrn1 mutant embryos show abnormal expression of asymmetrically expressed genes involved in LR patterning. A range of complex heart defects was observed in 20-25% of mid-to-late gestation Mgrn1 mutant embryos and another 20% were dead. This finding was consistent with 46-60% mortality of mutants by weaning age. Our results indicate that Mgrn1 acts early in the LR signaling cascade and is likely to provide new insight into this developmental process as Nodal expression was uncoupled from expression of other Nodal-responsive genes in Mgrn1 mutant embryos. Our work identifies a novel role for MGRN1 in embryonic patterning and suggests that the ubiquitination of MGRN1 target genes is essential for the proper establishment and/or maintenance of the LR axis.