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Therapy of psoriasis with retinoid plus PUVA: Clinical and histologic data

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Summary

In a group of 40 patients suffering from wide-spread psoriasis oral administration of a retinoid (Ro 10-9359) was followed by PUVA therapy. The clearance rate was increased by 30% as compared to PUVA alone. Except for cheilitis no side effects were seen. Histological analysis in 20 patients before, during and after therapy revealed an intensification of psoriatic tissue changes after retinoid treatment. Loss of corneal layers, massive exoserosis, and neutrophil migration were prominent features. Mitotic counts were not increased by the pretreatment. The increased susceptibility of diseased skin to PUVA as produced by this drug appears to be based on several factors related to the tissue changes revealed by histology.

Zusammenfassung

Vierzig Patienten mit ausgedehnter Psoriasis vulgaris wurden mit einem Retinoid (Ro 10-9359) über 2 Wochen vorbehandelt. Anschließend erfolgte eine zusätzliche Therapie mit PUVA. Die Hautveränderungen heilten im Vergleich zu PUVA allein signifikant schneller ab. Außer einer Cheilitis fanden sich keine auffälligen Nebenwirkungen. Histologisches Merkmal der retinoid-induzierten Gewebsveränderungen waren weitgehender Verlust des Stratum corneum, Exoserose und eine starke Exocytose von Neutrophilen. Die mitotische Aktivität der retinoid-vorbehandelten Psoriasis war nicht verändert. Die höhere Empfindlichkeit der retinoid-vorbehandelten Haut gegenüber der nachfolgenden PUVA-Therapie beruht möglicherweise auf mehreren Faktoren, die mit den histologisch sichtbaren Gewebsveränderungen korrelieren.

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Authors and Affiliations

  1. Department of Dermatology, University of Kiel, Schittenhelmstraße 7, D-2300, Kiel, Federal Republic of Germany

    G. Heidbreder & E. Christophers

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  1. G. Heidbreder
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  2. E. Christophers
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Heidbreder, G., Christophers, E. Therapy of psoriasis with retinoid plus PUVA: Clinical and histologic data. Arch Dermatol Res 264, 331–337 (1979). https://doi.org/10.1007/BF00412661

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