ABSTRACT
BACKGROUND: Ultraviolet (UV) A1 phototherapy is an effective anti-inflammatory treatment modality that influences fibroblast functions. OBJECTIVES: To document the effects of UVA1 treatment in patients with localized scleroderma (LS) in a retrospective study (at least 6 months after UVA1 treatment) and in a prospective study before and immediately after medium-dose UVA1 irradiation. METHODS: In total, 30 patients (retrospective study n = 17, prospective study n = 13) with LS receiving UVA1 phototherapy five times weekly (for 3-6 weeks) were investigated. Improvement was documented using standardized questionnaires and clinical evaluation (using modified Rodnan skin score, Cutometer and 7.5-MHz ultrasound measurements). Levels of collagen I and collagen III metabolites were measured in serum and urine. RESULTS: In the retrospective study, medium-dose UVA1 phototherapy had been performed 6 months-3 years earlier (cumulative dose 750-1400 J cm(-2); mean + or - SD number of irradiations 19.3 + or - 3.8). Fourteen of 17 patients (82%) reported an improvement in symptoms following UVA1 therapy. In the prospective study, skin elasticity increased in 77% of the patients following medium-dose UVA1 phototherapy (cumulative dose 750-1250 J cm(-2); mean + or - SD number of irradiations 20.8 + or - 4.0). 7.5-MHz ultrasound measurements showed a mean reduction of lesional skin thickness of 13% compared with skin thickness before UVA1 phototherapy. The ratio of deoxypyridinoline to creatinine was significantly elevated in about two-thirds of the patients. CONCLUSIONS: This open study showed a positive short- and long-term efficacy of UVA1 phototherapy in patients with LS, with a reduction in sclerotic plaques, an increase in skin elasticity and a reduction of lesional skin thickness. UVA1 phototherapy had a significant effect on collagen metabolism. UVA1 phototherapy can be regarded as a safe treatment modality for patients with LS.
Subject(s)
Scleroderma, Localized/radiotherapy , Ultraviolet Therapy/methods , Adult , Aged , Collagen/metabolism , Female , Humans , Male , Middle Aged , Prospective Studies , Retrospective Studies , Scleroderma, Localized/metabolism , Severity of Illness Index , Treatment Outcome , Ultraviolet RaysABSTRACT
Scleredema adultorum is a rare connective tissue disorder of unknown cause. Both bath-PUVA and cream-PUVA therapy were reported to be effective. We describe a patient with scleredema adultorum who showed a striking clinical improvement with a medium-dose UVA1 phototherapy (single dose, 50 J/cm(2); 35 treatments).
Subject(s)
Scleredema Adultorum/radiotherapy , Ultraviolet Therapy , Humans , Male , Middle Aged , Radiotherapy DosageABSTRACT
We describe the case of a 51-year-old male patient with characteristic lesions of keratosis lichenoides chronica confined to the back of his hands and feet. The lichenoid papules, linear hyperkeratotic ridges and erythematosquamous plaques appeared first in early childhood and recurred after a short episode of spontaneous remission. They didn't respond to various topical treatment modalities over the years. After a local PUVA therapy all lesions disappeared with no recurrence for over two years now. Our case report indicates a new promising indication for bath-PUVA-therapy.
Subject(s)
Balneology , Foot Dermatoses/therapy , Hand Dermatoses/therapy , Lichenoid Eruptions/therapy , PUVA Therapy , Chronic Disease , Combined Modality Therapy , Foot Dermatoses/diagnosis , Foot Dermatoses/pathology , Hand Dermatoses/diagnosis , Hand Dermatoses/pathology , Humans , Lichenoid Eruptions/diagnosis , Lichenoid Eruptions/pathology , Male , Middle Aged , Skin/pathologyABSTRACT
Invasion of basement membranes is a key step in systemic spread of tumour cells. To analyze genetic mechanisms involved in this process, we have selected strongly and weakly invasive sublines with stable phenotypes from a primary human melanoma cell line by repeated passage through a reconstituted basement membrane in vitro. The sublines differed approximately 5-fold in their invasive potential. Invasiveness correlated with better attachment and overexpression of the integrin alpha v/beta 3 (vitronectin/laminin-receptor). Treatment with retinoic acid inhibited proliferation in both sublines and invasion in the weakly invasive cells but stimulated invasion in the strongly invasive subline. Northern-blot analyses revealed equal levels of mRNA expression regarding collagenase type-IV and retinoic-acid receptors but enhanced expression of TIMP-2 mRNA in weakly invasive cells. The 2 sublines differed significantly in their respective DNA ploidy when compared to the wild-type Mel Im cell line, suggesting that they represent heterogeneous clones present in the primary tumour. We have started to exploit this in vitro system for tumour heterogeneity to clone genes involved in invasion. By a subtractive cDNA cloning strategy, 12 partial cDNA clones were obtained that are specifically overexpressed in the strongly or weakly invasive subline. These results illustrate that stable genetic alterations lead to heterogeneous subpopulations within primary melanomas which differ in their ability to invade basement membranes and interact with components of the extracellular matrix.
Subject(s)
DNA, Complementary/isolation & purification , DNA, Neoplasm/isolation & purification , Gene Expression Regulation, Neoplastic , Melanoma/pathology , Neoplasm Invasiveness/pathology , Neoplasm Proteins/genetics , Skin Neoplasms/pathology , Actins/biosynthesis , Actins/genetics , Aneuploidy , Clone Cells/pathology , Cloning, Molecular , Collagen , Collagenases/biosynthesis , Collagenases/genetics , DNA, Complementary/genetics , DNA, Neoplasm/genetics , Disease Progression , Drug Combinations , Humans , Integrins/biosynthesis , Integrins/genetics , Laminin , Melanoma/genetics , Neoplasm Invasiveness/genetics , Neoplasm Proteins/biosynthesis , Protein Biosynthesis , Proteins/genetics , Proteoglycans , Receptors, Cytoadhesin/biosynthesis , Receptors, Cytoadhesin/genetics , Receptors, Vitronectin , Selection, Genetic , Skin Neoplasms/genetics , Tissue Inhibitor of Metalloproteinase-2 , Tretinoin/pharmacology , Tumor Cells, Cultured/drug effects , Tumor Cells, Cultured/pathologyABSTRACT
An occupational health survey was conducted on workers, who inhale petrol fumes which contain low concentrations of benzene, at petrol filling stations in the city of Rangoon, Burma. To evaluate the exposure to benzene, urinary phenol (which is a principal metabolite of absorbed benzene) was measured in workers at petrol filling stations and in a control group of healthy male adults. The survey revealed that the urinary phenol content of workers exposed to petrol fumes was significantly higher than that of workers who were not exposed.