Treatment of bath PUVA-induced skin pain with gabapentin

Abstract

patients were not being treated by haemodialysis or peritoneal dialysis. Blood was collected immediately after the start of haemodialysis in the case of patients on haemodialysis and before breakfast in the case of other patients. All the patients in the study had given written informed consent that had been approved by the Ethics Committee of Oita University. We measured serum levels of 5-S-CD by high-performance liquid chromatography with electrochemical detection as described by Wakamatsu et al. 4 Levels of both blood urea nitrogen and serum creatinine were measured by conventional methods. With the exception of the samples from the patient with acute renal failure and from patients with relatively good renal function, all serum samples contained elevated levels of 5-S-CD. Although the blood level of urea nitrogen and the serum level of 5-S-CD were somewhat correlated (correlation coefficient 0AE59), serum levels of creatinine and 5-S-CD were strongly correlated ( Fig. 1; correlation coefficient 0AE78; P ¼ 4AE5 · 10 )5 by Spearman's rank correlation). Serum levels of 5-S-CD and creatinine clearance were inversely correlated, although there was variation in values.5-S-cysteinyldopa is a 316-kDa precursor of phaeomelanin and is produced by melanocytes and some nonmelanogenic cells. 5 The renal clearance of 5-S-CD was reported to be about 80 mL min )1 in healthy subjects 4,6 and 69-30 mL min )1 in patients with metastatic melanoma. 7 These values correspond to 70% and 44% of the creatinine clearance rate, respectively. Although rates of renal clearance of 5-S-CD varied, our analysis showed clearly that a high level of serum 5-S-CD in cases of chronic renal failure does not always mean the aggravation of malignant melanoma. Thus care should be exercised in the interpretation of elevated levels of 5-S-CD. Y . A s a d a S . A r a k a w a S . F u j i w a r a

British Association of Dermatologists and British Photodermatology Group guidelines for the safe and effective use of psoralen–ultraviolet A therapy 2015

“…Treatment with analgesics, topical anaesthetics and topical or systemic steroids usually has minimal effect. Capsaicin, gabapentin, phenytoin and low‐frequency electrotherapy can potentially be of benefit . Once PUVA pain has developed it is then a relative contraindication to further PUVA treatment, as pain is likely to recur.…”

“…Capsaicin, gabapentin, phenytoin and low-frequency electrotherapy can potentially be of benefit. [220][221][222][223][224] Once PUVA pain has developed it is then a relative contraindication to further PUVA treatment, as pain is likely to recur.…”

A review on PUVA pricks—A debilitating adverse event

“…From a search of 1.228 unique articles, 9 articles were retrieved published between 1979 and 2005 4,5,7–14 . From these articles, 33 patients are extracted.…”

“…The sensation has been reported as persistent and severe, with burning or prickling pain “deep under the skin.” 8 The severity is described as “more intense than renal colic” and disabling for daily life. Patients are on PUVA therapy for several weeks to months before they experience this complaint, sometimes occurring after therapy cessation due to other side effects 4,11,13 . Paroxysmal episodes can last from seconds to minutes up to several hours, occurring spontaneously or provoked by scratching and pressure on the skin.…”

Sunlight-induced Painful Skin (Sun Pain): A New Differential Diagnosis in Photodermatology

“…However, unlike the current patients and the patients with facial dysesthesia ( 22 ), accessional episodes of pain occurred for days or weeks even in the absence of sun exposure, often following scratching or pressure to the skin, and usually resolving spontaneously and definitively only after several weeks ( 23 , 24 ). It is notable that good results were reported with gabapentin ( 25 ) that was also used successfully for improving symptoms in patients with facial dysesthesia ( 22 ) and in one of the 2 current patients with fibromyalgia.…”