Summary
A technique is described to successfully treat patients with extreme sensitivity to UV electromagnetic wave lengths with photochemotherapy. Representative data from a patient with solar urticaria and two patients with persistent light reaction are given. Prior to treatment the threshold doses for UV-C, UV-B, and UV-A were determined. Photochemotherapy was performed with standard 8-methoxypsoralen-UV-A (PUVA) schedules. Initial treatments were very difficult because of the extreme UV-sensitivity in all patients. Once pigmentation was induced, PUVA-treatments were easy to perform.
All patients became almost free of symptoms and were able, for the first time in years, to resume normal outdoor activities. Remission was long-lasting.
Photochemotherapy is offered as a new effective means to alleviate the symptoms of disabling photodermatoses.
Zusammenfassung
Es wird ein Verfahren zur Photochemotherapie von Patienten mit extremer Empfindlichkeit auf elektomagnetische Strahlung im UV-Bereich beschrieben. Zwei Patienten mit persistierender Lichtreaktion und eine Patientin mit Lichturtikaria werden kasuistisch vorgestellt.
Jeweils vor und nach der Therapie wurde die Reaktionsschwelle für UV-C, UV-B und UV-A bestimmt. Die Photochemotherapie erfolgte entsprechend dem standardisierten Schema der 8-Methoxypsoralen-UV-A-Therapie (PUVA). Wegen der extremen Lichtempfindlichkeit der Patienten, gestaltete sich die Therapie anfangs schwierig. Nach Stimmulierung einer ausreichenden Pigmentierung konnte die PUVA-Behandlung problemlos fortgesetzt werden.
Bei allen Patienten kam es zu einer vollständigen und langanhaltenden Remission. Die Patienten konnten sich erstmals nach langer Zeit wieder ungehindert der direkten Sonnenbestrahlung aussetzten.
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References
Brenner W, Gschnait F, Hönigsmann H, Fritsch P (1978) Erprobung von PUVA bei verschiedenen Dermatosen. Hautarzt 29:541–544
Braun-Falco O, Hofmann C, Plewig G (1977) Feingewebliche Veränderungen unter Photochemotherapie der Psoriasis. Arch Dermatol Res 257:307–317
Braun-Falco O, Hofmann C, Plewig G (1977) Photochemotherapy of psoriasis: clinical and histological findings. In: Farber EM, Cox AJ, Jacobs PH, Hall ML (Hrsg) Psoriasis. Yorke Medical Books, New York, pp 310–319
Gschnait F, Brenner W, Wolff K (1978) Photoprotective effect of a psoralen-UVA-induced tan. Arch Dermatol Res 263:181–188
Gschnait F, Hönigsmann H, Brenner W, Fritsch P, Wolff K (1978) Induction of UV light tolerance by PUVA in patients with polymorphous light eruption. Br J Dermatol 99:293–295
Hölzle E, Hofmann C, Plewig G (1980) Experimental reproduction of skin lesions in polymorphous light eruptions. Arch Dermatol Res 267:215
Hofmann C, Burg G, Plewig G, Braun-Falco O (1977) Photochemotherapie kutaner Lymphome. Orale und lokale 8-MOP-UVA-Therapie. Dtsch Med Wochenschr 102:675–679
Hofmann C, Weissmann I, Plewig G (1979) Pityriasis lichenoides chronica-eine neue Indikation zur PUVA-Therapie? Dermatologica 159:451–460
Kobza A, Ramsay CA, Magnus IA (1973) Oral β-carotene therapy in actinic reticuloid and solar urticaria. Br J Dermatol 88:157–166
Konrad K, Gschnait F, Hönigsmann H, Fritsch P, Wolff K (1978) Photochemotherapie bei Mykosis fungoides. Hautarzt 29:191–197
Lowe NJ, Cripps DJ, Dufton PA, Vickers CFH (1979) Photochemotherapy for mycosis fungoides. A clinical and histological study. Arch Dermatol 115:50–53
Mathews-Roth MM, Pathak MA, Fitzpatrick TB, Harber LH, Kass EH (1977) Beta carotene therapy for erythropoietic protoporphyria and other photosensitivity diseases. Arch Dermatol 113:1229–1232
Morison WL, White HAD, Gonzalez E, Parrish JA, Fitzpatrick TB (1979) Oral methoxalen photochemotherapy of uncommon photodermatoses. Acta Derm Venereol 59:366–368
Mutzhas MF, Hölzle E, Hofmann C, Plewig G (1980) A new apparatus with high radiation energy between 320–460 nm. J Invest Dermatol 73 (in press)
Ortonne JP, Thivolet J, Sannwald C (1978) Oral photochemotherapy in the treatment of lichen planus. Br J Dermatol 99:77–88
Pathak MA, Fitzpatrick TB (1974) The role of natural photoprotective agents in human skin. In: Pathak MA, Harber LC, Seiji M, Kukita A (Hrsg) Sunlight and man. University Press, Tokyo, pp 725–750
Ramsay CA (1977) Solar urticaria treatment by inducing tolerance to artificial radiation and natural light. Arch Dermatol 113:1222–1225
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The present study was supported by grant Br 147/51 of the Deutsche Forschungsgemeinschaft
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Hölzle, E., Hofmann, C. & Plewig, G. PUVA-Treatment for solar urticaria and persistent light reaction. Arch Dermatol Res 269, 87–91 (1980). https://doi.org/10.1007/BF00404462
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DOI: https://doi.org/10.1007/BF00404462
Key words
- Solar urticaria
- Persistent light reaction
- Photochemotherapy of photodermatoses
- Photodermatoses
- PUVA-treatment
- 8-Methoxy-psoralen-UV-A-photochemotherapy