Summary
Local photochemotherapy with trioxsalen baths and long‐wave ultraviolet radiation (UV‐A) was used in nineteen patients with lichen planus and five patients with urticaria pigmentosa. Widespread papular lichen planus healed totally in all sixteen patients. Hypertrophic lichen planus was more resistant to therapy; two out of three patients recovered completely and in one the result was good. The average total UV‐A dose in papular lichen planus was only 6 J/cm2. In urticaria pigmentosa good results were gained in all five patients treated with respect to whealing, itching and dermographism, and in one patient the lesions disappeared completely.
Good results were achieved in psoriasis with trioxsalen baths and UVA in 92% of 158 patients during initial treatment and in 83% of 139 patients during long-term treatment. Grade I-II local burns were encountered in about 7% of the patients. In addition, itchy skin pain was experienced by 2 patients, and in both of these the therapy was discontinued. Neither skin malignomas nor other serious side effects were seen.
Short-duration dithranol therapy (SDDT) was compared to Dithrocream® therapy in an open trial for the treatment of psoriasis. SDDT is based on the application of highly concentrated (1–2%) dithranol (anthralin) for a short period of time (10–20 min) and appeared to be clearly less staining and more comfortable than Dithrocream (0.1–0.5%). Both treatment methods appeared to be clinically effective; the SDDT method was slightly more effective than Dithrocream in this study.
Fourteen patients with necrobiosis lipoidica (NL) were carefully evaluated clinically and histologically. Ten of these patients (71%) had diabetes and most of them were treated with insulin (8 of 10 patients). Trauma was found as an immediate triggering factor in 6 patients (43%) and a possible preceding factor in 3 more cases. No immunoglobulins were found in the lesional skin of NL. Intradermal injections of histamine in healthy skin of legs led to deposition of immunoglobulins and complement (C3) in skin blood vessel walls in 4 of 12 patients studied (30%). These results suggest that immune complexes might be involved only in few cases of NL. Preceding trauma combined with metabolic and inflammatory changes could be an important triggering factor in the etiology of NL.
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