A randomized comparison of selective broadband UVB and narrowband UVB in the treatment of psoriasis.

UVB is widely used to treat psoriasis. Conventional broadband UVB lamps are less effective than narrowband UVB lamps, which have an emission peak at 311 nm. The long-term safety of narrowband UVB phototherapy is uncertain. "Selective" broadband UVB lamps, which have little emission <290 nm, are also available, but have not been adequately compared to narrowband UVB lamps. We performed a randomized comparison of narrowband UVB (TL-01 lamps) and selective broadband UVB (UV6 lamps) in 100 patients with psoriasis. The median number of exposures for clearance was 28.4 for TL-01 and 30.4 for UV6 (ratio of the medians 0.93; 95% confidence interval (CI) 0.80, 1.09; P=0.39). No significant difference was found in the proportion of patients achieving clearance: TL-01 56%, UV6 40% (odds ratio for clearance with TL-01 relative to UV6 was 2.00 (95% CI 0.87, 4.62), P=0.10). Side effects, including the development of erythema during phototherapy, were similar for the two lamp types. Risk estimates based on the human photocarcinogenesis action spectrum predict that narrowband UVB lamps will be 50% more carcinogenic for equal erythemal doses than selective broadband lamps (UV6). As these two lamp types appear to be of similar efficacy, phototherapy using a selective broadband source may be a safer option than use of narrowband UVB.

Juvenile xanthogranuloma associated with contralateral lymphadenopathy.

Juvenile xanthogranuloma is an uncommon, benign histiocytic condition, primarily affecting children less than 1 year of age. Although usually only cutaneous lesions are found, systemic manifestations of the disease have been reported. We present a child with juvenile xanthogranuloma of the right cheek associated with contralateral cervical lymph node histiocytic infiltration.

MTHFD1 R653Q polymorphism is a maternal genetic risk factor for severe abruptio placentae.

This study examined the relationship between folate/homocysteine-related genetic polymorphisms: MTHFD1 1958G --> A (R653Q), MTHFR 677C --> T (A222V), MTHFR 1298A --> C (E429A), and risk of severe abruptio placentae. We genotyped 62 women with a pregnancy history complicated by severe abruptio placentae and 184 control pregnancies. Analysis of the MTHFD1 1958G --> A (R653Q) polymorphism showed increased frequency of the 'QQ' homozygote genotype in pregnancies affected by severe abruptio placentae compared to control pregnancies (odds ratio 2.85 (1.47-5.53), P = 0.002). In contrast to previous reports, the MTHFR polymorphisms 677C --> T (A222V) and 1298A --> C (E429A) were not associated with abruptio placentae risk in our cohort, when analyzed either independently or in combination. We conclude that women who are 'QQ' homozygote for the MTHFD1 1258G --> A (R653Q) polymorphism are almost three times more likely to develop severe abruptio placentae during their pregnancy than women who are 'RQ' or 'RR.'