A new development in UVB phototherapy of psoriasis

Weelden, Huib van; Faille, H. Baart de la; Young, E.; Leun, Jan C. van der

doi:10.1111/j.1365-2133.1988.tb07096.x

Cited by 280 publications

(177 citation statements)

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“…2A) (16). This very large dose is more than 14,000 times the average broadband UVB minimal erythema dose (17) and shows that the stiffness is largely insensitive to UV exposure. We selected UV dosages above those that are physiologically normal to amplify tissue responses and ensure we would observe easily detectable effects.…”

Section: Resultsmentioning

confidence: 99%

Solar UV radiation reduces the barrier function of human skin

Biniek

Levi

Dauskardt

2012

Proc. Natl. Acad. Sci. U.S.A.

248

219

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The ubiquitous presence of solar UV radiation in human life is essential for vitamin D production but also leads to skin photoaging, damage, and malignancies. Photoaging and skin cancer have been extensively studied, but the effects of UV on the critical mechanical barrier function of the outermost layer of the epidermis, the stratum corneum (SC), are not understood. The SC is the first line of defense against environmental exposures like solar UV radiation, and its effects on UV targets within the SC and subsequent alterations in the mechanical properties and related barrier function are unclear. Alteration of the SC's mechanical properties can lead to severe macroscopic skin damage such as chapping and cracking and associated inflammation, infection, scarring, and abnormal desquamation. Here, we show that UV exposure has dramatic effects on cell cohesion and mechanical integrity that are related to its effects on the SC's intercellular components, including intercellular lipids and corneodesmosomes. We found that, although the keratin-controlled stiffness remained surprisingly constant with UV exposure, the intercellular strength, strain, and cohesion decreased markedly. We further show that solar UV radiation poses a double threat to skin by both increasing the biomechanical driving force for damage while simultaneously decreasing the skin's natural ability to resist, compromising the critical barrier function of the skin.T he stratum corneum (SC), as the outermost layer of the epidermis, is the body's first line of defense against solar UV radiation. Solar UV radiation plays a dual role in human life: it is pivotal for vitamin D production (1) while also a potent and ubiquitous carcinogen responsible for much of the skin cancer in the human population (2). Although progress has been made in understanding the role of UV radiation in causing skin cancer (3), the role of solar UV radiation in altering the mechanical barrier function of the SC remains unknown.The SC provides both critical mechanical protection and a controlled permeable barrier to the external environment. Although the SC is typically a highly efficient barrier, exposure to harsh conditions can alter its function, leading to severe skin damage such as chapping and cracking. Such damage can cause detrimental skin responses including inflammation and infection caused by compromised barrier function, scarring, and abnormal desquamation, and further aggravate the effects of skin disorders such as atopic dermatitis, ichthyosis vulgaris, and chronic xerosis (4-7).UV radiation is divided into three main types based on wavelength: UVC radiation (200-280 nm) is predominately filtered by the ozone layer in the stratosphere, UVB radiation (280-320 nm) is mainly absorbed by the epidermis, and UVA radiation (320-400 nm) penetrates deeper into the dermis but interacts with both the SC and epidermis as well (8) (Fig. 1). The penetration of UV radiation into the skin can initiate detrimental photochemical reactions, causing both acute conditions such as erythem...

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Section: Resultsmentioning

confidence: 99%

Solar UV radiation reduces the barrier function of human skin

Biniek

Levi

Dauskardt

2012

Proc. Natl. Acad. Sci. U.S.A.

248

219

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“…Bu keşif, psoriasiste, 296 nm'den kısa dalgaboyuna sahip ışınların eritemojenik olduklarını ancak terapötik olmadıklarını göstermiş, daha uzun dalga boyuna sahip ışınlarla monokromatik irradyasyon yapıldığında, psoriatik plakların suberitemojenik dozlarda daha kısa sürede iyileştikleri bilgisini ortaya çıkarmıştır. Bu bilgiden hareketle Phillips tarafından 311±2 nm dalgaboyuna sahip floresan lambalar geliştirilmiş ve böylece, psoriasiste dar bant UVB fototerapisi doğmuştur (9,10). Bu tedavi, sadece psoriasiste değil, vitiligo, atopik dermatit, mikozis fungoides, pitriyazis likenoides ve daha pek çok farklı deri hastalığında etkin bulunmuş, günümüzde artık geniş bant UVB tedavisinin yerini almıştır.…”

Section: Fototerapinin Tarihçesiunclassified

Current Approach to Phototherapy Applications in Dermatology Practice: Part 1. History, Lamps, Ultraviolet Radiation Levels Measurement and Phototherapy Modalities

Gençosmanoğlu¹

2017

tdd

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Dermatolojik tedavide son yıllarda önemli gelişmeler olmaktadır. Dermatoloji tarihindeki en eski tedavi yöntemlerinden biri olan fototerapi, bu gelişmelerin gerisinde kalmayıp, tam tersine, etkin ve güvenilir olmasının avantajıyla, pek çok deri hastalığının tedavisinde yaygın olarak kullanılmaya devam etmektedir. Bu makale, mevcut fototerapi yöntemlerinin tarihçesinden başlayarak, yapay ultraviyole kaynakları, bu kaynakların dozimetre ve kalibrasyon standartları ve ultraviyole tedavi protokolleri konusunda pratik ve temel bilgiler verebilmeyi hedeflemektedir. Öz AbstractLately, important advances take place in dermatological treatment. Phototherapy, as one of the oldest treatment modalities in the history of dermatology, does not fall behind these advances; on the contrary, it is still used widely in the treatment of many skin diseases with the advantages of being effective and safe. This article aims to give practical and basic information about artificial ultraviolet sources, dosimetry and calibration standards of these sources and ultraviolet treatment protocols, starting with the history of current phototherapy modalities. Keywords: Dosimetry, calibration, history, psoralen ultraviolet A, ultraviolet B, phototherapy Sürekli Eğitim / Continuing Medical Education 1 Turk J Dermatol 2017;11:1-11 • DOI: 10.4274/tdd.3233 GirişDermatoloji tarihindeki en eski tedavi yöntemlerinden biri olan fototerapi, dermatolojik tedavideki gelişmelerin gerisinde kalmayıp, etkin ve güvenilir olmasının avantajıyla, pek çok deri hastalığında yaygın olarak kullanılmaya devam etmektedir. Psoriasis, mikozis fungoides, atopik dermatit, vitiligo ve polimorf ışık erüpsiyonu gibi patogenezleri tamamen farklı hastalıkları tedavi edebilen fototerapi, bu özelliğiyle, dermatolojideki tedavi seçenekleri arasında özel bir yere sahiptir. Fototerapinin TarihçesiFototerapinin tarihçesi binlerce yıl öncesine dayanır. 3500 yıl önce Mısır'da, o zaman lepra olduğu sanılan vitiligoda, Nil deltasında yetişen ve psoralen içeren bir bitki olan Ammi majus'u kaynatarak içtikten sonra güneşe çıkmak bir tedavi yöntemiydi. Modern fototerapide ilk adımlar, "fototerapinin babası" olarak bilinen Niels Ryberg Finsen tarafından atılmıştır. Güneş ışığının antibakteriyel etkileri olduğunu farkeden Finsen, yapay bir ultraviyole (UV) lambası geliştirmiş ve bu "Finsen lambası" ile, 800'den fazla lupus vulgaris hastasını tedavi ederek, %80'inde kür sağlamış, bu buluşuyla 1903 yılında Nobel ödülü kazanmıştır. Dermatoloji tarihinde Nobel ödülü alan ilk ve tek kişidir (1-3).Fototerapi alanına yaptığı katkılarla ismi anılması gereken isimlerden bir diğeri de Goeckerman'dır. Goeckerman, Mayo klinikte, halen kendi adıyla anılmakta olan bir fototerapi yöntemi geliştirmiş ve elde ettiği ilk sonuçları 1925 yılında yayınlamıştır. Psoriasis hastalarında uygulanan bu yöntemde, yüksek basınçlı civa lambaları ile geniş bant UVB uygulamasını izleyerek deriye kömür katranı sürülmektedir (4). Goeckerman rejimi, günümüzde popüler bir tedavi yöntemi değildir. Ancak, biyolojikler da...

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“…1 Because it has only recently been introduced as a therapeutic tool, the long-term carcinogenic risk of NBUVB is, however, not yet firmly established. 18,31 There are conflicting data from murine studies, [32][33][34][35][36] and only a few studies in humans have considered its relative carcinogenicity.…”

Section: Nbuvb Phototherapymentioning

confidence: 99%

The dark side of the light: Phototherapy adverse effects

Coelho

Apetato

2016

Clinics in Dermatology

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Phototherapy is a valuable therapeutic tool in Dermatology, but there may be drawbacks. Acute and long-term adverse effects, of variable severity, include skin erythema, xerosis, pruritus, blistering, altered pigmentation, photoaging, and photocarcinogenesis. Despite concerns over the carcinogenic potential of ultraviolet radiation, most studies have not found an increased risk of non-melanoma or melanoma skin cancer in patients treated with ultraviolet B (broadband and narrowband) and ultraviolet A1 phototherapy. These are therefore considered reasonably safe treatment modalities concerning the development of skin neoplasms, although caution and further investigation are warranted. Photoprotective measures, such as avoidance of concurrent sunlight exposure and covering skin areas not afflicted with disease, or more modern strategies, including phytochemical antioxidants and exogenous DNA repair enzymes, can minimize the hazards of phototherapy. Patients submitted to phototherapeutic regimens should undergo complete, careful dermatologic examination regularly and lifelong.

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A new development in UVB phototherapy of psoriasis

Cited by 280 publications

References 9 publications

Solar UV radiation reduces the barrier function of human skin

Solar UV radiation reduces the barrier function of human skin

Current Approach to Phototherapy Applications in Dermatology Practice: Part 1. History, Lamps, Ultraviolet Radiation Levels Measurement and Phototherapy Modalities

The dark side of the light: Phototherapy adverse effects

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