Six years’ experience of grenz ray therapy for the treatment of inflammatory skin conditions

Fenton, L.; Dawe, Robert S.

doi:10.1111/ced.12960

Cited by 16 publications

(25 citation statements)

References 20 publications

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“…It has recently been reported to stimulate the expression of cancertestis antigens and MHC-I molecules of tumor cells [13] , as well as to cause local activation of complement [14] and increasing immune reaction in such a manner. Grenz rays have been reported to be a good treatment option for a number of inflammatory skin conditions [15] . Given the superficial location of pathology, low-energy radiation, such as grenz and soft rays (20 kV), that is absorbed within the first 2 mm of the skin [16] , is suitable for the treatment of DSAP.…”

Section: Resultsmentioning

confidence: 99%

Successful Use of Grenz Rays for Disseminated Superficial Actinic Porokeratosis: Report of 8 Cases

et al. 2017

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Background: Disseminated superficial actinic porokeratosis (DSAP) is a rare keratinization disorder with potential malignant transformation, for which present treatment strategies show limited success. Aim: To evaluate the response of DSAP lesions to grenz ray radiotherapy (RTx). Methods: Data of patients treated with RTx at University Hospital Zurich, Switzerland, between 2004 and 2015, were reviewed. Patients with DSAP, who received at least 1 RTx treatment session and who had been followed up for at least 4 weeks were included in the further data analysis. Results: The study cohort consisted of 8 patients with a median age of 73 years (range 54-84). All were treated with grenz rays for DSAP. Most (7/8) patients showed complete clinical clearing of the lesions. All patients experienced temporary side effects of RTx, which resolved within 4 weeks after the last irradiation. Conclusion: We suggest radiotherapy with grenz rays as a treatment option for DSAP.

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Section: Resultsmentioning

confidence: 99%

Successful Use of Grenz Rays for Disseminated Superficial Actinic Porokeratosis: Report of 8 Cases

et al. 2017

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“…Furthermore, in a study in nine patients with PPP, three courses of Grenz ray therapy at a dose of 5 Gy per treatment produced marked improvement, and the improvement was sustained for 3 months' follow-up [92].…”

Section: Phototherapymentioning

confidence: 96%

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

2020

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Palmoplantar pustulosis (PPP) is a chronic, recurrent skin disease belonging to the spectrum of psoriasis. It is characterized by an eruption of sterile pustules on the palms and soles. Recent studies in PPP have focused on genetic differences between pustular phenotypes and the role of the innate immunological system and the microbiome in the etiopathogenesis of the disease. Mutations in IL36RN (a major predisposing factor for generalized pustular psoriasis) were found in selected patients with PPP and were associated with earlier disease onset. Studies have shown that the interleukin (IL)-17 and IL-36 pathways might be involved in the pathogenesis of PPP. A microbiome has been demonstrated in the vesicopustules of PPP, and an abundance of Staphylococcus appears to be increased by smoking. Improved understanding of the underlying etiopathogenesis of PPP has led to advances in treatment options, and targeted therapies for PPP have been evaluated or are under evaluation against more than 12 molecules in ongoing clinical trials.

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“…The response was assessed using PGA and a modified total lesion/symptom score (mTLSS). The authors stated that compared to other UV therapies, Excimer laser offers lower cumulative doses of UV radiation by targeting specific areas and should be considered alone or in combination with other established or newer therapies. Grenz rays: Small case series show some benefits from Grenz rays in the treatment of chronic hand eczema, 52,53 but a NICE guideline notes the evidence is very limited 54 . There is some concern about the risk of skin malignancy in the long term, but Grenz remains an option for recalcitrant hyperkeratotic hand eczema. Botulinum toxin: In a trial in 10 patients with vesicular hand dermatitis, botulinum toxin A (mean dose ‐ 162 units) was injected in one hand, using the untreated hand as a control 55 .…”

Section: Physical Therapiesmentioning

confidence: 99%

“…The authors stated that compared to other UV therapies, Excimer laser offers lower cumulative doses of UV radiation by targeting specific areas and should be considered alone or in combination with other established or newer therapies. • Grenz rays: Small case series show some benefits from Grenz rays in the treatment of chronic hand eczema, 52,53 but a NICE guideline notes the evidence is very limited. 54 There is some concern about the risk of skin malignancy in the long term, but Grenz remains an option for recalcitrant hyperkeratotic hand eczema.…”

Section: Topical Treatmentmentioning

confidence: 99%

Management of chronic hand and foot eczema. An Australia/New Zealand Clinical narrative

et al. 2020

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Chronic hand/foot eczemas are common, but treatment is often challenging, with widespread dissatisfaction over current available options. Detailed history is important, particularly with regard to potential exposure to irritants and allergens. Patch testing should be regarded as a standard investigation. Individual treatment outcomes and targets, including systemic therapy, should be discussed early with patients, restoring function being the primary goal, with clearing the skin a secondary outcome. Each new treatment, where appropriate, should be considered additive or overlapping to any previous therapy. Management extends beyond mere pharmacological or physical treatment, and requires an encompassing approach including removal or avoidance of causative factors, behavioural changes and social support. To date, there is little evidence to guide sequences or combinations of therapies. Moderately symptomatic patients (e.g. DLQI ≥ 10) should be started on a potent/super‐potent topical corticosteroid applied once or twice per day for 4 weeks, with tapering to twice weekly application. If response is inadequate, consider phototherapy, and then a 12‐week trial of a retinoid (alitretinoin or acitretin). Second line systemic treatments include methotrexate, ciclosporin and azathioprine. For patients presenting with severe symptomatic disease (DLQI ≥ 15), consider predniso(lo)ne 0.5–1.0 mg/kg/day (or ciclosporin 3 – 5 mg/kg/day) for 4–6 weeks with tapering, and then treating as for moderate disease as above. In non‐responders, botulinum toxin and/or iontophoresis, if associated with hyperhidrosis, may sometimes help. Some patients only respond to long‐term systemic corticosteroids. The data on sequencing of newer agents, such as dupilumab or JAK inhibitors, are immature.

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Six years’ experience of grenz ray therapy for the treatment of inflammatory skin conditions

Cited by 16 publications

References 20 publications

Successful Use of Grenz Rays for Disseminated Superficial Actinic Porokeratosis: Report of 8 Cases

Successful Use of Grenz Rays for Disseminated Superficial Actinic Porokeratosis: Report of 8 Cases

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

Management of chronic hand and foot eczema. An Australia/New Zealand Clinical narrative

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