RESUMO
Epidermal Langerhans' cells (LC) were studied in patients with chronic eczematous dermatitis of the palms. The monoclonal antibodies anti-Leu 6 and anti-HLA-DR were used, and the cells visualized with an immunoperoxidase technique. Increased numbers of LC were found in allergic contact dermatitis as well as in irritant contact dermatitis and hyperkeratotic dermatitis of the palms. The increased number of epidermal LC in lesional skin may facilitate presentation of exogenous or endogenous antigens to activated T-cells. One hand was treated with PUVA or UVB and the other hand served as a non-exposed control. PUVA treatment cleared the dermatitis and the LC number decreased markedly. With UVB treatment clinical improvement was achieved, and a less pronounced decrease in epidermal LC was noticed. There seems to be a crude relationship between the extent of clinical improvement and the reduction in epidermal LC numbers. The change in LC might be a primary event or secondary to a reduction of the inflammatory process.
Assuntos
Dermatite de Contato/imunologia , Células de Langerhans/patologia , Terapia PUVA , Terapia Ultravioleta , Adulto , Contagem de Células , Doença Crônica , Dermatite de Contato/tratamento farmacológico , Dermatite de Contato/radioterapia , Feminino , Dermatoses da Mão/imunologia , Dermatoses da Mão/terapia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Distribuição AleatóriaRESUMO
Epidermal Langerhans' cells (LC) were studied in patients with pustulosis palmoplantaris (PPP) by utilizing the monoclonal antibodies anti-Leu6 and anti-HLA-DR in combination with an immunoperoxidase technique. In non-pustular areas of the skin lesions in PPP, an increased number of epidermal LC was found compared with control subjects. No change in LC counts was observed following etretinate monotherapy for 2 weeks. Etretinate was then combined with PUVA treatment of one palm/sole with the contralateral side as a non-UVA exposed control. After 6-12 weeks of etretinate + PUVA treatment the PPP had resolved and the number of epidermal dendritic HLA-DR+ and Leu6+ cells had normalized. On the contralateral side, etretinate treatment induced a marked clinical improvement and a reduction of HLA-DR+ cells. The observation of an increased LC population in active PPP and a reduction during clinical improvement indicates a close relationship between LC and the activity of PPP.
Assuntos
Etretinato/uso terapêutico , Dermatoses do Pé/patologia , Dermatoses da Mão/patologia , Células de Langerhans/efeitos dos fármacos , Terapia PUVA , Adulto , Idoso , Anticorpos Monoclonais , Contagem de Células/métodos , Terapia Combinada , Feminino , Dermatoses do Pé/tratamento farmacológico , Dermatoses da Mão/tratamento farmacológico , Humanos , Técnicas Imunoenzimáticas , Células de Langerhans/imunologia , Masculino , Pessoa de Meia-IdadeRESUMO
Thirty patients with severe pustulosis palmoplantaris completed a placebo-controlled comparative trial. Patients were randomly allocated to placebo or etretinate therapy; after two weeks, psoralen plus long-wave ultraviolet light (PUVA) treatment was instituted on one hand or foot, while the other hand or foot served as an untreated control. Fourteen of 18 hands or feet cleared with the combined treatment, compared with three of 18 with etretinate treatment and three of 12 with PUVA treatment. Follow-up showed a high relapse rate. Treatment of severe pustulosis palmoplantaris must be individualized to minimize short- and long-term side effects.
Assuntos
Etretinato/uso terapêutico , Terapia PUVA , Psoríase/tratamento farmacológico , Adulto , Idoso , Ensaios Clínicos como Assunto , Etretinato/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição AleatóriaRESUMO
The efficacy of PUVA and UVB treatment in chronic eczematous dermatitis of the hands was compared in a randomised controlled study including 35 patients who were randomly allocated to PUVA or UVB treatment. One hand was exposed to light and the other served as an untreated control. The dermatitis cleared on the treated hand in all PUVA patients, but in 9 out of 14 there was a relapse within three months. In the UVB group clearing of the skin lesions was not achieved, but compared with the "untreated" hands a statistically significant improvement was found at 12 weeks of treatment. A statistically significant improvement of "untreated" hands was found in both groups. PUVA and UVB treatments are alternative treatment modalities in patients with recalcitrant chronic eczematous dermatitis of the hands. PUVA is superior to UVB.
Assuntos
Dermatite de Contato/terapia , Dermatoses da Mão/terapia , Terapia PUVA , Terapia Ultravioleta , Ensaios Clínicos como Assunto , Feminino , Humanos , Masculino , Distribuição AleatóriaRESUMO
Oral psoralen photochemotherapy (PUVA) was found to be effective in five patients with chronic hyperkeratotic dermatitis of the palms. Relapses may occur but they respond well to retreatment.