Efficacy and safety of excimer light (308 nm) in the treatment of pityriasis lichenoides chronica.

INTRODUCTION: Pityriasis lichenoides chronica is the chronic end of the spectrum of pityriasis lichenoides which have several forms of papulosuamous conditions. Several treatments obtained complete clearance of the condition including phototherapy and specifically narrow band ultraviolet B. The Excimer light 308 is a monochromatic light that acts within the ultraviolet B wavelength and used as a targeted phototherapy in several skin conditions. METHODS: Thirty-four patients with histopathologically diagnosed pityriasis lichenoides chronica underwent treatment with biweekly sessions of excimer light 308 nm. Treatment continued until complete clearance was obtained or to a maximum of 48 sessions (24 weeks). RESULTS: Thirty-one patients obtained complete clearance with no recurrence till the end of the study period, two patients had partial response and only one patient showed poor response to treatment. CONCLUSION: Excimer light can be a safe and effective treatment of pityriasis lichinoides chronica in different ages and genders.

Narrowband ultraviolet B phototherapy for pityriasis lichenoides: A real-life experience.

INTRODUCTION: Pityriasis lichenoides (PL) is a papulosquamous disease affecting both children and adults, for which narrowband-UVB (NB-UVB) phototherapy is regarded as a commonly used treatment option. The aim of this study was to investigate the efficacy of NB-UVB phototherapy in the management of PL and to compare response rates in pediatric and adult age groups. MATERIALS AND METHODS: This observational, retrospective study included 20 PL patients (12 pityriasis lichenoides chronica; PLC, 8 pityriasis lichenoides et varioliformis acuta; PLEVA) who failed to respond to other treatment modalities. The data for this study were collected retrospectively from patient follow-up forms in the phototherapy unit. RESULTS: A complete response (CR) was obtained in all pediatric patients with PL, while 53.8% of adult patients had achieved CR. The mean cumulative dose required to achieve the CR was higher in pediatric patients than adult patients with PL (p < .05). The CR was achieved in 6 (75%) of 8 PLEVA patients, while 8 (66.7%) of 12 PLC patients had reached to CR. The mean number of exposures for patients with PLC to achieve a CR was higher than patients with PLEVA (p < .05). Erythema was the most common adverse effect during phototherapy particularly in 5 (35.7%) of the patients with PL who had achieved CR. CONCLUSIONS: NB-UVB is an effective and well-tolerated treatment option for PL especially in diffuse types. A higher response can be obtained in children with higher cumulative dose. Patients with PLC may require more exposures for CR than patients with PLEVA.

Frequency of occurrence of polymorphic light eruption in patients treated with photohardening and patients treated with phototherapy for other diseases.

BACKGROUND: Medical phototherapy can lead to the manifestation of polymorphic light eruption (PLE), though little is known about the frequency of such events. AIMS: The aim of this Austrian single center study was to retrospectively investigate over a 4-year time period the frequency of PLE in patients prone to the condition and patients with other diseases under phototherapy (mainly narrow-band and broad-band UVB). MATERIALS AND METHODS: The data for analysis were obtained from the electronic health and patient record database and patient files of the Photodermatology Unit, Department of Dermatology, Medical University of Graz, Austria. RESULTS: PLE occurred in 24.3% (18/74) of PLE patients but only 0.7% (3/421) of psoriasis patients under phototherapy (chi-square; P < 0.0001). PLE also occurred in 1.2% (3/257) of patients with atopic eczema, 0.8% (1/118) with prurigo, 3.5% (4/115, P = 0.0206) with parapsoriasis en plaques/mycosis fungoides, 7.4% (2/27, P = 0.0013) with granuloma anulare, 14.3% (1/7, P = 0.0002) with scleroderma, and 16.7% (1/6, P < 0.0001 vs. psoriasis) with pityriasis lichenoides chronica or pityriasis lichenoides eruptiva et varioliformis acuta. DISCUSSION AND CONCLUSION: These results are helpful for treatment allocation and risk estimation of PLE occurrence with regard to obtaining informed consent not only from PLE-prone patients but also from patients with other skin disorders commonly treated by phototherapy.

Treatment of adult diffuse pityriasis lichenoides chronica with narrowband ultraviolet B: experience and literature review.

Pityriasis lichenoides chronica (PLC) is an infrequent dermatosis of unknown aetiology, wholse evolution and response to treatment differs between children and adults. When PLC is recalcitrant or unresponsive to topical treatment, phototherapy is one of the main treatments used. We carried out a prospective study of adult diffuse PLC treated with narrowband ultraviolet B (NB-UVB). We treated eight patients whose disease showed no response to topical therapy, and obtained a complete response rate of 88% in a mean of 23 sessions (cumulative dose 16.99 J/cm2 ). However, the relapse rate was 43% in the first 6 months. Our results are similar to those of other published studies but there is much variability between them in the doses applied and the number of sessions needed. Further studies are necessary to devise a protocol for NB-UVB treatment of PLC.

Successful treatment of pityriasis lichenoides chronica with narrow-band ultraviolet B therapy in a patient with Keratitis-Ichthyosis-Deafness syndrome: a case report.

Keratitis-ichthyosis-deafness (KID) syndrome is a rare genodermatosis causing ichthyosis-like skin lesions, keratitis, and deafness. Herein, we report a patient with this rare syndrome in association with pityriasis lichenoides chronica, which was succesfully treated with narrow-band ultraviolet B phototherapy despite our concerns regarding the increased risk of squamous cell carcinoma, hyperpyrexia, and keratitis.

Phototherapy in children: Considerations and indications.

Phototherapy can be a safe and effective treatment for various skin diseases in children. Special considerations governing the use of this treatment modality in pediatric populations include patient, family, and facility-based factors that are oriented around heightened concerns with regard to safety and tolerability of treatment. Although phototherapy has been found to be effective in a wide range of dermatologic conditions affecting pediatric populations, including psoriasis, atopic dermatitis, pityriasis lichenoides, cutaneous T-cell lymphoma, and vitiligo, there is need for additional research on other conditions in which phototherapy has shown promise.

Is narrowband ultraviolet B monotherapy effective in the treatment of pityriasis lichenoides?

BACKGROUND: Pityriasis lichenoides (PL) is a self-limiting papulosquamous disease that may persist for years and is associated with a high relapse rate. To date, few comparative studies have investigated the efficacy of narrowband ultraviolet B (NB-UVB) phototherapy and other therapies in the treatment of PL. OBJECTIVES: The present study retrospectively compared the clinical efficacies of NB-UVB phototherapy, systemic therapy, and a combination of NB-UVB and systemic medication in the treatment of PL. METHODS: Seventy patients diagnosed with PL were enrolled in this study. They were divided into three subgroups: the NB-UVB treatment group; the systemic treatment group; and the combination treatment group. Therapeutic efficacy was evaluated according to whether the subjects demonstrated a complete response (> 90% improvement in skin lesions), partial response (50-90% improvement), or no response (< 50% improvement) to treatment. RESULTS: A 91.9% complete response rate was achieved in the NB-UVB group, whereas only 69.2 and 80.0% of patients achieved a complete response in the systemic and combination treatment groups, respectively; these differences were not statistically significant. The mean treatment periods were 8.3, 5.3, and 7.9 weeks in the NB-UVB, systemic, and combination treatment groups, respectively; these differences were also not significant. CONCLUSIONS: Monotherapy using NB-UVB is effective in achieving a complete response in the treatment of PL and thus eliminates the need for concurrent systemic medication.

Comparison of the therapeutic effects of narrow band UVB vs. PUVA in patients with pityriasis lichenoides.

BACKGROUND AND AIMS: Pityriasis lichenoides (PL) is a self-limiting papulosquamous skin disorder with chronic course. Best therapeutic options are yet to be defined. Phototherapy is one of the most prevalent treatments and the aim of this study was to compare the therapeutic effects of the two main phototherapy options: psoralen plus ultraviolet A (PUVA) and narrow band UVB (NB-UVB). MATERIAL AND METHODS: Patients with PLC based on clinical findings and pathology, involving at least 60% of total body surface, were enrolled if they were not pregnant, lactating women and had not contraindication for phototherapy. Based on simple randomization, they received either PUVA or NB-UVB, and patients' responses were recorded. RESULTS: A total of 15 patients including eight males (53%) and seven females (47%) were enrolled in the study and were randomized into groups A and B, each including four patients. In group A, seven patients had complete response (87.5%) and one patient had partial response (12.5%). Among patients in group B, five patients had complete response (71.4%) and two patients (28.6%) had partial response (P > 0.05). CONCLUSION: As the difference between the two groups is insignificant, it seems that both options are acceptable for treating this disorder.

Narrowband ultraviolet-B phototherapy in pityriasis lichenoides chronica.

BACKGROUND: Current knowledge about the efficacy of narrowband UVB therapy for the treatment of pityriasis lichenoides is limited. OBJECTIVE: The aim of this study was to investigate the efficacy of narrowband UVB therapy for the treatment of pityriasis lichenoides chronica (PLC). METHODS: Data were retrospectively collected following a review of patient phototherapy and medical charts, and telephone interviews were performed for follow-up information. RESULTS: The study included 25 patients (14 male, 11 female) with a mean age of 34 +/- 13 years. Diagnosis was confirmed by histopathological examination in 92% (n = 23) of the patients. The median duration of the disease was 24 months (range: 2-192 months). The median number of sessions until response was 25 (8 weeks) (range: 9-77 sessions), with a median cumulative dose of 15 J/cm(2) (range: 2-158 J/cm(2)). Complete response and partial response were achieved in 48% and 44% of the patients, respectively, while 8% of the patients achieved no response. In those patients for whom follow-up data were available (n = 17), 10 (58%) relapsed within a median of 9.5 months (range: 1-44 months). CONCLUSIONS: Our results suggest that narrowband UVB is an effective and well-tolerated treatment option for PLC.

Narrowband UVB (311 nm, TL01) phototherapy for pityriasis lichenoides.

BACKGROUND/PURPOSE: Narrowband (NB) UVB (NB-UVB) phototherapy has recently demonstrated high levels of efficacy and tolerability in a variety of skin diseases. The purpose of the present study was to assess the efficacy of NB-UVB phototherapy in the management of pityriasis lichenoides (PL). METHODS: The therapeutic response in 31 PL patients (23 pityriasis lichenoides et varioliformis acuta; PLEVA, eight pityriasis lichenoides chronica; PLC) treated with NB-UVB phototherapy between 2000 and 2007 was assessed. RESULTS: NB-UVB treatment led to a complete response (CR) in 15 out of 23 PLEVA patients (65.2%) with a mean cumulative dose of 23 J/cm(2) after a mean number of 43.4 exposures and a partial response (PR) in eight patients (34.8%) with a cumulative dose of 15.6 J/cm(2) after a mean number of 32.3 exposures. NB-UVB treatment led to CR in seven out of eight PLC patients (87.5%) with a mean cumulative dose of 18.4 J/cm(2) after a mean number of 45.8 exposures and PR in one patient (12.5%) with a cumulative dose of 9.1 J/cm(2) after a mean number of 19 exposures. Relapses occurred in four PL patients within a mean time period of 6 months. CONCLUSION: NB-UVB therapy is an effective, safe and practical alternative treatment modality for the management of PLEVA and PLC.

UVB therapy of pityriasis lichenoides--our experience with 29 patients.

BACKGROUND: Pityriasis lichenoides comprises a clinical and pathological spectrum of disorders. So far no highly effective treatment has been reported. Previous small studies have suggested that ultraviolet B (UVB) is a good alternative. METHODS: This is a retrospective analysis of 29 pityriasis lichenoides patients treated in our institution with broad- or narrow-band UVB during the period 1996-2002. Twenty-one of these patients had one or more previous unsuccessful treatments. RESULTS: Complete response was achieved in 93.1% in both treatment groups, with 73% of them still relapse free after a mean follow-up of 58 and 38 months in broad- and narrow-band UVB treatment groups, respectively. Mild side-effects were observed in about one-third of the patients. CONCLUSION: We believe both forms of UVB are a good option for pityriasis lichenoides and should be considered as the first line in generalized cases interested in treatment.

Infectious causes of pityriasis lichenoides: a case of fulminant infectious mononucleosis.

Pityriasis lichenoides is a rare cutaneous eruption of unknown cause that spans a spectrum of clinical severity. Infectious agents have long been suspected as etiologic factors. The present case is the first to demonstrate a known EBV-mediated process evolving and resolving in concert with pityriasis lichenoides. Epstein-Barr virus, Toxoplasma gondii, and HIV are the most frequently reported infectious triggers of pityriasis lichenoides. Pityriasis lichenoides may arise secondary to EBV-mediated acute infectious mononucleosis.

Medium-dose ultraviolet A1 therapy for pityriasis lichenoides et varioliformis acuta and pityriasis lichenoides chronica.

BACKGROUND: Ultraviolet A1 (340-400 nm) was found to be effective in the treatment of cutaneous T-cell-mediated diseases. OBJECTIVE: The purpose of the present study was to assess the efficacy of UVA1 phototherapy for pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis lichenoides chronica (PLC). METHODS: Eight patients (3 with PLEVA and 5 with PLC) received 60 J/cm(2) UVA1 daily until remission. Four patients also had lesions inaccessible to UVA1 that were used as control lesions. Immunocytologic studies of skin infiltrates and circulating T cells were done. RESULTS: Six patients showed complete clinical and histologic recovery. Two patients with PLC had a partial improvement. Unirradiated control lesions never improved. Serious short-term adverse effects were not encountered. No effects on circulating lymphocytes were reported. CONCLUSION: UVA1 therapy is an effective and well-tolerated treatment for PLEVA and PLC. The therapeutic activity seems to be related to direct effects on cutaneous inflammatory infiltrates because the lesions in nonexposed cutaneous areas did not respond.

Experience with UVB phototherapy in children.

Twenty children age 14 months to 12 years with photoresponsive dermatoses were treated with ultraviolet B (UVB) phototherapy over four years. Ten children had psoriasis, five had pityriasis lichenoids, and five had atopic dermatitis. All received short courses (average 34 treatments) of phototherapy with either no maintenance or short maintenance. Treatment was effective and well tolerated in most patients, and no serious side effects were seen. Patients with psoriasis and pityriasis lichenoides cleared completely. No patient with atopic dermatitis cleared completely, but all were moderately improved, with reduction of the extent of eczema and decreased pruritus. It appears that UVB phototherapy is a valuable and safe therapeutic option for selected children who do not respond to other treatments.