A large scale analytical study on efficacy of different photo(chemo)therapeutic modalities in the treatment of psoriasis, vitiligo and mycosis fungoides

Abstract

Psoriasis, vitiligo, and mycosis fungoides (MF) are among the most frequently treated dermatological diseases by photo(chemo)therapy. The objectives are to determine which photo (chemo) therapeutic modality could achieve the best response in the treatment of psoriasis, vitiligo, and MF. The design used in this study is retrospective analytical study. The study included 745 patients' records; 293 with psoriasis, 309 with vitiligo, and 143 with early MF, treated in the Phototherapy Unit, Dermatology Department, Kasr El-Aini Hospital, Cairo University by either psoralen and ultraviolet A (PUVA), narrow band ultraviolet B (NB-UVB), psoralen and narrow band UVB (P-NBUVB), broad band UVB (BB-UVB), or broad band UVA (BetaBeta-UVA). Data were retrieved from the computer database of the unit and statistically analyzed. In psoriasis, oral and topical PUVA and NB-UVB were found to be equally effective, whereas oral PUVA had significantly better results than both UVA and BB-UVB at the end of therapy. In generalized vitiligo, PUVA and P-NBUVB had significantly better results than NB-UVB alone. In early MF, there was no statistically significant difference between the response to oral PUVA and NB-UVB. PUVA and NB-UVB are good choices in patients with psoriasis and early stage MF, whereas PUVA appears the best choice in the treatment of vitiligo.

Psoralea corylifolia protects against testicular torsion/detorsion-induced ischemia/reperfusion injury

“…These results suggest that Psoralea corylifolia may protect against testicular torsion/detorsion-induced spermatogenic injury by enhancing CREM expression. Recent study has shown that Psoralea corylifolia treatment for psoriasis and vitiligo is efficacious and safe in clinical use (El-Mofty et al, 2010). Therefore, it is reasonable to suggest that clinical application of Psoralea corylifolia may be a useful new approach for therapy of testicular torsion, as an addition to conventional detorsion.…”

Ultraviolet B (UVB) Phototherapy in the Treatment of Vitiligo

“…Targeted BB-UVB and MEL were found to have nearly equal rates and degrees of repigmentation when evaluated after 8 treatments (Asawanonda, Kijluakiat et al, 2008). Nearly 60% of patients had 80-100% repigmentation after 70 BB-UVB treatment sessions, a rate comparable to topical PUVA (55.6%) and NB-UVB (54.2%) treated patients in the same trial (El-Mofty, Mostafa et al, 2010). Other studies suggest that BB-UVB is less effective or had no effect compared to PUVA and NB-UVB phototherapy for the treatment of vitiligo (Hartmann, Lurz et al, 2005;Gawkrodger, Ormerod et al, 2008).…”

“…Furthermore, NB-UVB is suggested as the best choice for generalized disease, with topical immunomodulators (i.e., pimecrolimus cream or tacrolimus ointment) reserved for localized patches (Stinco, Piccirillo et al, 2009). Prognosis is significantly better in those with generalized vitiligo without acral involvement, and reportedly in females (El-Mofty, Mostafa et al, 2010 …”

Phototherapy in vitiligo

“…A retrospective analytical study [28] at Phototherapy Unit, Kasr Al Aini Hospital reviewed 309 vitiligo patients over 10 years, who were treated with oral and topical PUVA, BB-UVA, NB-UVB, BB-UVB, and psoralen NB-UVB. Among these patients, 150 were treated with oral PUVA and 96 were treated with NB-UVB.…”