Psoralens and UV-A-induced stellate hyperpigmented freckling

Background:Systemic oral psoralens plus UVA therapy (PUVA) is a therapeutic method used with considerable success in many different skin disorders. PUVA therapy causes some cutaneous and noncutaneous side effects and in the present research we deal with cutaneous side effects.Aims:Evaluation of patients to know the different skin side effects of PUVA and their importance.Materials and Methods:All patients referred to the phototherapy unit of Imam Reza Hospital of Mashhad entered the research and skin examination was taken place initially and every 3 months thereafter. Whenever any side effect appeared, it was recorded in the information sheet.Results:One hundred and twenty-eight patients were included in the research, 61 were male between 15 and 75 years and 67 were female between 10 and 61 years of age. Age of female patients at the time of cutaneous side effect appearance was less than male patients. The most common early side effect was pruritus (34.3%) and the rarest was telangiectasia (0.7%). One case of late side effect in the form of squamous cell carcinoma was observed in a patient who had received other carcinogenic drugs as well. Complications such as skin dryness, pruritus, erythema and burning sensation occurred at low doses of UVA, while dermatitis, severe limb pain and acne at moderate doses and PUVA lentigines, hypertrichosis and lichenoid lesions appeared at high doses of UVA.Conclusion:Considering the significant therapeutic effects and few serious side effects, PUVA therapy is a suitable and safe method for treatment of certain skin diseases.

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“…It may be diffuse, poikiloderma-like, or in a naevus spilus-like pattern producing gross freckling (PUVA lentigines). [1011]…”

Section: Discussionmentioning

confidence: 99%

Evaluation of PUVA-induced skin side effects in patients referred to the Imam Reza Hospital of Mashhad in 2005-2007

et al. 2014

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“…Histologically, they are characterized by a lentiginous proliferation of large melanocytes which, in some cases, may be atypical 4 . Very occasionally, large 5 or atypical 6 lentigines have been reported in individual patients, but in the cases of atypical lentigines the lesions were individual or few 6 . Our patient is thus unusual in developing numerous large very atypical lesions.…”

Section: Discussionmentioning

confidence: 99%

Atypical pigmented lesions following extensive PUVA therapy

Basarab

Millard

McGregor

et al. 2000

Clinical and Experimental Dermatology

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We report a 38-year-old woman with psoriasis who developed multiple atypical lentigines following psoralen photochemotherapy (PUVA). The lentigines first appeared 12 years ago, 3 years after she commenced intermittent PUVA treatment. New lesions continued to develop over the subsequent years with further photochemotherapy. Clinically, the lentigines were strikingly atypical, deeply pigmented, dark brown or black, large stellate macules. Histology of a representative lesion was consistent with a PUVA lentigo and no atypical melanocytes were seen. At present, a link between malignant melanoma and PUVA lentigines has not been established. Instead, limited evidence suggests that PUVA lentigines may be more closely linked with the risk of nonmelanoma skin cancer.

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“…91 PUVA induces freckling, and a tendency toward freckling is associated with melanoma risk. 92 Although several reports suggest that the use of tanning beds influences the development of melanoma, the power and design of these studies has been criticized 93 Also, although most tanning beds currently emit mainly UVA radiation, there were differences in the amount of UVB emitted before 1980. With a lack of standardization of dosages among facilities that still exist today, it is difficult to assess risk.…”

Section: Roles Of Uvb Versus Uvamentioning

confidence: 99%

“…A prospective analysis of patients undergoing psoralen and UVA treatment (PUVA) for skin disease has shown an increased risk for melanoma, which follows a dose‐response curve 91 . PUVA induces freckling, and a tendency toward freckling is associated with melanoma risk 92 . Although several reports suggest that the use of tanning beds influences the development of melanoma, the power and design of these studies has been criticized 93 Also, although most tanning beds currently emit mainly UVA radiation, there were differences in the amount of UVB emitted before 1980.…”

Section: Roles Of Uvb Versus Uvamentioning

confidence: 99%