and Other Papulosquamous Disorders
- UVB Therapy
Walters IB, Burack LH, Coven TR, et al (Rockefeller Univ, New York)
Suberythemogenic Narrow-Band UVB Is Markedly More Effective Than Conventional UVB in Treatment of Psoriasis Vulgaris
J Am Acad Dermatol 40: 893-900, 1999
6 men and 5 women with plaque type psoriasis of a mean duration of 15.3 years were studied on a split-body basis.
Mineral oil was applied to the plaques. To reduce burning and pain of UVB narrow band the dose was decreased to 50% of the minimum erythema dose.
The dose of broad band UVB was kept at 75%. Both are as compared to the minimal erythemogenic doses required.
Response to UVB narrow band was far superior to the broad band. Keratin 16 stain was negative in skin biopsy of narrow band UVB after treatment in 75 per cent.
- UV Therapy
Tanew A, Radakovic-Fijan S, Schemper M, et al (Univ of Vienna, Austria)
Narrowband UV-B Phototherapy vs Photochemotherpay in the Treatment of Chronic Plaque-Type Psoriasis: A Paired Comparison Study
Arch Dermatol 135: 519-524, 1999
This paper weighs the effect of narrow band UV-B rays against conventional PUVA therapy in chronic psoriatic plaques.
After exposing the right dorsal surface to narrow band UV-B light, the subjects swallowed psoralen capsules. After an hour UVA was administered to the left side while protecting the right side.
The authors conclude both to be effective but PUVA was better. They suggest PUVA for patients resistant to narrow band UV-B rays.
- Molin L, and the Calcipotriol-UVB Study Group (Orebro Med Ctr Hosp, Sweden)
Topical Calcipotriol Combined With Phototherapy for Psoriasis: The Results of Two Randomized Trials and a Review of the Literature
Dermatology 198: 375-381, 1999
The study deals with stable plaque type psoriasis. One group was treated with calcipotriol on both sides of the body and UVB on one side. The second received calcipotriol ointment on one side and a vehicle on the other. UV-B was used on both sites.
The ointment (50 mg/g) was applied twice a day and UV-B exposure near the erythema dose was administered twice a week.
The authors conclude that calcipotriol increases the effectivity of UV-B light, thus reducing total UV-B exposure.
- Brands S, Brakman M, Bos JD, et al (Univ of Amsterdam; Reinier de Graaf Gasthuis, Delft, The Netherlands)
No Additional Effect of Calcipotriol Ointment on Low-Dose Narrow-Band UVB Phototherapy in Psoriasis
J Am Acad Dermatol 41: 991-995, 1999
Calcipotriol in combination with broad-band UV-B gives a better result than the ointment alone.
Application of the ointment 2 hours before exposure to narrow band UV-B despite increasing doses of the latter did not produce additional benefit.
The authors did not advise this combination.
- Tanew A, Ortel B, Honigsmann H (Univ of Vienna, Austria; Harvard Med School, Boston)
Half-Side Comparison of Erythemogenic Versus Suberythemogenic UVA Doses in Oral Photochemotherapy of Psoriasis
J Am Acad Dermatol 41: 408-413, 1999
Effectivity and erythema production have become interwoven in PUVA therapy. Because of possibilities of skin cancer with cumulative toxicity a lower dose is worked out in this paper.
After establishing the minimal phototoxic dose (MPD), one side of the body received IMPD and the other 75 per cent of it or 50% in the second trial.
The authors conclude that both lower doses are equally effective and the cumulative dose is lower.
- Gordon PM, Diffey BL, Matthews JNS, et al (Royal Victoria Infirmary, Newcastle upon Tyne, England; Newcastle Gen Hosp, Newcastle upon Tyne, England; Univ of Newcastle, Newcastle upon Tyne, England)
A Randomized Comparison of Narrow-Band TL-01 Phototherapy and PUVA Photochemotherapy for Psoriasis
J Am Acad Dermatol 41: 728-732, 1999
The TL-01 fluorescent UV-B lamp is used for delivering 83% radiation around 311 nm. When compared to PUVA this is less effective, but still useful for milder forms of psoriasis.
- Kagan A, Husza’r M, Frumkin A, et al (Kaplan Med Ctr, Rehovot, Israel)
Reversal of Nephrotic Syndrome Due to AA Amyloidosis in Psoriatic Patients on Long-term Colchicine Treatment: Case Report and Review of the Literature
Nephron 82: 348-353, 1999
A 25 year old female with erythrodermic psoriasis and arthropathy of the hands is described. She had a nephrotic syndrome and AA Amyloidosis. Corticosteroids methotrexate and plasmapheresis did not produce a change, in 10 years of her disease.
All parameters returned to normal with cochicine, iron and lovastatin for 4 ½ years. At this point recurrence of skin lesions, raised erythrocyte sedimentation rate and hypoalbuminemia were noted.
- Park SB, Suh DH, Youn JI (Seoul Natl Univ, Korea)
A Pilot Study to Assess the Safety and Efficacy of Topical Calcipotriol Treatment in Childhood Psoriasis
Pediatr Dermatol 16: 321-325, 1999
This is an uncontrolled open study to determine whether calcipotriol is effective in psoriasis affecting the age group of 8 to 15 years. Duration of treatment was up to 106 weeks, with clearance or stabilization as end points.
1,25-dihydroxy vitamin D3 serum levels were reduced and need to be monitored. Authors conclude that the treatment is safe and effective.
Comment: Total clearance or cure are not claimed.