The technique of high frequency sonography in relation to preoperative diagnosis of malignant melanomas has high priority. In contrast to clinical estimation of tumour thickness, sonography provided a good correlation to histology. The effectiveness of sonography with regard to the valence of the skin tumours is limited and there is no possibility of differentiating between malignant and benign tumours from the morphological face value. Hence, there is a demand for developing a 150 MHz apparatus which will be able to supply evidence regarding the valence of skin tumours.
Two patients, a nine year old girl and a 59 year old woman, presented with extensive and recalcitrant lichen sclerosus et atrophicus (LSA). Both patients were treated with low-dose ultraviolet-A1 (UVA1) phototherapy (340-400 nm) for ten weeks. The cumulative UVA1 dose was 800 J/cm(2), the single UVA1 dose was 20 J/cm(2). After 40 treatment sessions, the previously sclerotic skin lesions had almost completely cleared in both patients. In addition 20-MHz ultrasound examination and histological specimen revealed no further signs of sclerosis. UVA1 phototherapy seems to be a new and effective treatment for LSA with optimal patients' acceptance due to the absence of systemic side effects. UVA1 should be therefore considered as therapeutic option for LSA.
We examined whether it is possible to increase the antipsoriatic action by combining dithranol with a retinoid (tazarotene). In a randomized, open, prospective study with 50 psoriatic patients (22 females, 28 males, PASI>10) the antipsoriatic effectiveness of dithranol monotherapy to was compared combined therapy with dithranol and retinoid. The combination dithranol/retinoid (collective 2, reduction of the PASI from 17,2 to 2,8) revealed a significantly faster healing than the dithranol monotherapy (collective 1, reduction of the PASI from 18,5 to 4,8). The irritation of the combination therapy as evaluated with clinical score and laser doppler imaging was increased. Anti-psoriatic effectiveness of dithranol can be increased by combining it with tazarotene.
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