UVA1 in the Management of Dermatoses
Authors:
N. Čárska; M. Petrovajová; T. Danilla; V. Hegyi
Authors‘ workplace:
Detská dermatovenerologická klinika LFUK a DFNsP, Bratislava
prednosta doc. MUDr. Tibor Danilla, CSc.
Published in:
Čes-slov Derm, 88, 2013, No. 4, p. 170-176
Category:
Therapy
Overview
The longwave UVA1 light is a part of the UV light spectrum, emitting photons of wavelength 340–400 nm. As a treatment modality it was introduced in 1981. A modern therapeutical devices enable the treatment in high-dose (up to 130 J/cm2), middle-dose (40–70 J/cm2) and low-dose (10–30 J/cm2) regime. Its advantage is the possibility of application in childhood most frequently in atopic dermatitis, localized scleroderma, graft versus host disease (GvHD) and other dermatoses. In the course of the UV therapy the frequency, the dose, the cumulative dose and the side effects monitoring are important. UVA1 light therapy is a minimally invasive method and a highly effective therapeutic modality especially safe in pediatric dermatology also due to minor side effects and good tolerability
Key words:
UVA1 light – scleroderma – GvHD – atopic dermatitis – other dermatitis
Sources
1. AIBA, S., TABATA, N., OHTANI, H. et al. CD34+ spindle-shaped cells selectively disappear from the skin lesion of scleroderma. Arch. Dermatol., 1994, 130, p. 593–597.
2. ALP, H., ORBAK, Z., AKTAS, A. Scleredema adultorum due to streptococcal infection. Pediatr. Int., 2003, 45, p. 101–103.
3. ANDERSON, R.R., PARRISH, J. A. The optics of human skin. J. Invest. Dermatol., 1981, 77, p. 13–19.
4. ANDRES, C., KOLLMAR, A., MEMPEL, M., et al. Successful ultraviolet A1 phototherapy in the treatment of localized scleroderma: a retrospective and prospective study. Br. J. Dermatol., 2010, 162, p. 445–447.
5. BEATTIE, P. E., DAWE, R. S., IBBOTSON, S. H., FERGUSON, J. UVA1 phototherapy for treatment of necrobiosis lipoidica. Clin. Exp. Dermatol., 2006, 31, p. 235–238.
6. BREUCKMANN, F., STUECKER, M., ALTMEYER, P. et al. Modulation of endothelial dysfunction and apoptosis: UVA1-mediated skin improvement in systemic sclerosis. Arch. Dermatol. Res., 2004, 296, p. 235–239.
7. BREUCKMANN, F., VON KOBYLETZKI, G., AVERMAETE, A. et al. Modulation of cathepsin G expression in severe atopic dermatitis following medium-dose UVA1 phototherapy. BMC. Dermatol., 2002, 2, p. 12.
8. CAPEZZERA, R., VENTURINI, M., BIANCHI, D. et al. UVA1 Phototherapy of Netherton Syndrome. Acta Derm. Venerol., 2004, 84, p. 69–94.
9. CHAVAN, R., EL-AZHARY, R. Cutaneous graft-versus- -host disease: rationales and treatment options. Dermatologic Therapy, 2011, 24, p. 219–228.
10. CRUZ P., DOUGHERTY I., DAWSON B., KRUTMANN J. Unlike UVB, UVA-1 radiation does not activate HIV in human skin. J. Invest. Dermatol., 2000, 114, p. 842.
11. DARR, D., FRIDOVICH, I. Free radicals in cutaneous biology. J. Invest. Dermatol., 1994,102, p. 671–675.
12. DAWE, R. S. Ultraviolet A1 phototherapy. Br. J. Dermatol., 2003, 148, p. 626–637.
13. DONG, C., ZHU, S., WANG, T., et al. Deficient Smad7 expression: a putative molecular defect in scleroderma. Proc. Natl. Acad. Sci. USA, 2002, 99, p. 3908–3913.
14. EL-MOFTY, M., MOSTAFA, W., ESMAT, S., et al. Suggested mechanism of action of UVA phototherapy in morphea: a molecular study. Photodermatol. Photoimmunol. Photomed., 2004, 20, p. 93–100.
15. FITZPATRICK, T. B. The validity and practicality of sun-reactive skin types I through VI. Arch. Dermatol., 1988, 124, p. 869–871.
16. GAMBICHLER, T., OTHLINGHAUS, N., TOMI, N. S. et al. Medium-dose ultraviolet (UV) 1 vs. narrowband UVB phototherapy in atopic eczema: A randomized crossover study. Br. J. Dermatol., 2009, 160, p. 652–658.
17. GODAR, D. E. UVA1 radiation triggers two different final apoptotic pathways. J. Invest. Dermatol., 1999, 112, p. 3–12.
18. GODAR D, E., LUCAS, A. D. Ultraviolet-A1 (340-400 nm) – mediated receptor and cytokine changes of transformed lymphocytes. Photodermatol. Photoimmunol. Photomed., 2005, 21, p. 23–31.
19. GODAR, D. E., LUCAS, A. D. Spectral dependence of UV–induced immediate and delayed apoptosis: the role of membrane and DNA damage. Photochem. Photobiol., 1995, 62, p. 108–113.
20. GRABBE, J., WELKER, P., HUMKE, S., et al. High-dose ultraviolet A1 (UVA1), but not UVA/UVB therapy, decreases IgE-Binding cells in lesional skin of patients with atopic eczema. J. Invest. Dermatol., 1996, 107, p. 419–422.
21. GREWE, M., GYUFKO, K., KRUTMANN, J. Interleukin-10 production by cultured human keratinocytes: regulation by ultraviolet B and ultraviolet A1 radiation. J. Invest. Dermatol., 1995, 104, p. 3–6.
22. GRUNDMANN-KOLLMANN, M., BEHRENS, S., GRUSS, C. et al. Chronic sclerodermic graft-versus-host disease refractory to immunosuppressive treatment responds to UVA1 phototherapy. J. Am. Acad. Dermatol., 2000, 42, p. 134–136.
23. GRUSS, C., REED, J. A., ALTMEYER, P. et al. Induction of interstitial collagenase (MMP-1) by UVA1 phototherapy in morphea fibroblasts. Lancet, 1997, 350, p. 1295–1296.
24. GUTIERREZ-STEIL, C., WRONE-SMITH, T., SUN, X. et al. Sunlight-induced basal cell carcinoma tumor cells and ultraviolet-B-irradiated psoriatic plaques express Fas ligand (CD95L). J. Clin. Invest., 1998, 101, p. 33–39.
25. GUHL, S., HARTMANN, K., TAPKENHINRICHS, S. et al. Ultraviolet irradiation induces apoptosis in human immature, but not in skin mast cells. J. Invest. Dermatol., 2003, 121, p. 837–844.
26. HONIGSMANN, H. Phototherapy for psoriasis. Clin. Exp. Dermatol., 2001, 26, p. 343–350.
27. JACOBE, H.T., CAYCE, R., NGUYEN, J. UVA1 phototherapy is effective in darker skin: a review of 101 patients od Fitzpatrick skin types I-V. Br. J. Dermatol., 2008, 159, p. 691–696.
28. KERR, A. C., FERGUSON, J., ATTILI, S. K. et al. Ultraviolet A1 phototherapy: a British Photodermatology Group workshop report. Clin. Exp. Dermatol., 2012, p. 1–8.
29. KERSCHER, M., DIRSCHKA, T., VOLKENANDT, M. Treatment of localized scleroderma by UVA1 phototherapy. Lancet, 1995, 346, p. 1166.
30. KREUTER, A., HYUN, J., SKRYGAN, M. et al. Ultraviolet A1-induced downregulation of human beta-defensins and interleukin-6 and interleukin-8 correlates with clinical improvement in localized scleroderma. Br. J. Dermatol., 2006, 155, p. 600–607.
31. KREUTER, A., HYUN, J., SKRYGAN, M. et al. Ultraviolet A1 phototherapy decreases inhibitory SMAD7 gene expression in localized scleroderma. Arch. Dermatol. Res., 2006, 298, p. 265–272.
32. KRONAUER, C., EBERLEIN-KONIG, B., RING, J., BEHRENDT, H. Influence of UVB, UVA, and UVA1 irradiation on histamine release from human basophils and mast cells in vitro in the presence and absence of antioxidants. Photochem. Photobiol., 2003, 77, p. 531–534.
33. KRUTMANN, J., CZECH, W., DIEPGEN, T. et al. High- -dose therapy in the treatment of patients with atopic dermatitis. J. Am. Acad. Dermatol., 1992, 26, p. 225–230.
34. KRUTMANN J., GREWE, M. Involvement of cytokines, DNA damage, and reactive oxygen intermediates in ultraviolet radiation-induced modulation of intercellular adhesion molecule-1 expression. J. Invest. Dermatol., 1995, 105, p. 67–70.
35. KRUTMANN, J., HONIGSMANN H., ELMETS C. Dermatological Phototherapy and Photodiagnostic Methods. 2nd. Edition. Springer, 2009, ISBN 13 9783540366928.
36. KRUTMANN, J., MORITA, A. Therapeutic photomedicine. In: FREEDBERG, I. M., EISEN, A. Z., WOLFF, K. (eds) Fitzpatrickęs Dermatology in General Medicine. New York : McGraw Hill., 2003, p. 2469– 2477.
37. KRUTMANN, J., SCHOPF, E. High-dose-UVA1 phototherapy: a novel and highly effective approach for the treatment of acute exacerbation of atopic dermatitis. Acta Derm. Venereol. Suppl.(Stockh.), 1992, 176, p. 120–122.
38. LAPOLLA, W., YENTZER, B. A., BAGEL, J. et al. A review of phototherapy protocols for psoriasis treatment. J. Am. Acad. Dermatol., 2011, 64, p. 936–949.
39. MAJOIE, I. M., OLDHOFF, J. M., VAN WEELDEN, H. et al. Narrowband ultraviolet B and medium-dose ultraviolet A1 are equally effective in the treatment of moderate to severe atopic dermatitis. J. Am. Acad. Dermatol., 2009, 60, p. 77–84.
40. McGREGOR, J., HAWK, J. Acute effects of ultraviolet radiation on tha skin. In: FREEDBERGI, EISEN, A., WOLF, K. et al. Fitzpatrickęs dermatology in general medicine. 5th edt. Vol.134. New York: McGraw-Hill, 1999, p. 1555.
41. MORI, Y., CHEN, S. J., VARGA, J. Expression and regulation of intracellular SMAD signaling in scleroderma skin fibroblasts. Arthritis. Rheum., 2003, 48, p. 1964–1978.
42. MORITA, A., KOBAYASHI, K., ISOMURA, I. et al. Ultraviolet A1 (340–400 nm) phototherapy for scleroderma in systemic sclerosis. J. Am. Acad. Dermatol., 2000, 43, p. 670–674.
43. MUCHENBERGER, S., SCHOPF, E., SIMON, J. C. Phototherapy with UV-1 for generalized granuloma annulare. Arch. Dermatol., 1997, 133, p. 1605.
44. MUTZHAS, M. F., HOLZLE, E., HOFMANN, C. et al. A new apparatus with high radiation energy between 320–460 nm: physical description and dermatological applications. J. Invest. Dermatol., 1981, 76, p. 42–47.
45. PETERSEN, M., HANSEN, C., CRAIG, C. Ultraviolet A irradiation stimulates collagenase production in cultured human fibroblasts. J. Invest. Dermatol., 1992, 99, p. 440–444.
46. PINTON, P. C., CAPEZZERA, R., ZANE, C. et al. Medium-dose ultraviolet A1 therapy for pityriasis lichenoides et varioliformis acuta and pityriasis lichenoides chronica. J. Am. Acad. Dermatol., 2002, 47, p. 410–414.
47. PLETTENBERG, H., STEGE, H. et al. Ultraviolet A1 (340–400 nm) phototherapy for cutaneous T-cell lymphoma. J. Am. Acad. Dermatol., 1999, 41, p. 47–50.
48. POLDERMAN, M. C. A., VAN KOOTEN, C., SMIT, N. P. M. et al. Ultraviolet-A (UVA-1) radiation suppresses immunoglobulin production of activated B lymphocytes in vitro. Clin. Exp. Dermatol., 2006, 145, p. 528–534.
49. ROSE, R. F., TURNER, D., GOODFIELD, M. J. D., GOULDEN, V. Low-dose UVA1 phototherapy for proximal and acral scleroderma in systemic sclerosis. Photodermatol. Photoimmunol. Photomed., 2009, 25, p. 153–155.
50. RUNGER, T. M. Role of UVA in the pathogenesis of melanoma and non-melanoma skin cancer. Photodermatol. Photoimmunol. Photomed., 1999, 15, p. 212–216.
51. SIMON, J. C., PFIEGER, D., SCHOPF, E. Recent advances in phototherapy. Eur. J. Dermatol., 2000, 10, p. 642–645.
52. SCHALLER, M., ROMITI, R., WOLLENBERG, A. et al. Improvement of cutaneous manifestations of POEMS syndrome after UVA1 phototherapy. J. Am. Acad. Dermatol., 2001, 45, p. 969–970.
53. SCHOPP, C., TZANEVA, S., MEMPEL, M. et al. UVA1 phototherapy for disseminated granuloma annulare. Photodermatol. Photoimmunol. Photomed., 2005, 21, p. 68–71.
54. SCHWARTZ, S. M., BENNETT, M. R. Death by any other name. Am. J. Pathol., 1995, 147, p. 229–234.
55. STEGE, H., SCHOPF, E., RUZICKA, T., KRUTMANN, J. High-dose UVA1 for Urticaria pigmentosa. Lancet, 1996, 347, p. 64.
56. SZEGEDI, A., SIMICS, E., ALEKSZA, M. et al. Ultraviolet-A1 phototherapy modulates Th1/Th2 a Tc1/Tc2 balance in patients with systemic lupus erythematosus. Rheumatology, 2005, 44, p. 925–931.
57. STANDER, H., SCHILLER, M., SCHWARZ, T. UVA1 therapy for sclerodermic graft-versus-host disease of the skin. J. Am. Acad. Dermatol., 2002, 46, p. 799–800.
58. TEWARI, A., GARIBALDINOS, T., LAI-CHEONG, J. et al. Succesful treatment of microstomia with UVA1 phototherapy in systemic sclerosis. Photodermatol. Photoimmunol. Photomed., 2011, 27, p. 113–114.
59. TZANEVA, S., KITTLER, H., HOLZER, G., RELJIC, D., WEBER, M., HONIGSMANN, H., TANEW, A. 5-Methoxypsoralen plus ultraviolet (UV) A is superior to medium- -dose UVA1 in the treatment of severe atopic dermatitis: a randomized crossover trial. Br. J. Dermatol., 2010, 162, p. 655–660.
60. VON KOBYLETZKI, G., UHLE, A., PIECK, C. et al. Acrosclerosis in patients with systemic sclerosis responds to low-dose UV-1 phototherapy. Arch. Dermatol., 2000, 136, p. 275–276.
61. WETZIG, T., STICHERLING, M., SIMON, J. C. et al. Medium dose longwavelenght ultraviolet A (UVA1) phototherapy for the treatment of acute and chronic graft-versus-host disease of the skin. Bone Marrow Transplant., 2005, 35, p. 515–519.
62. WLASCHEK, M., HEINEN,G., POSWIG, A. et al. UVA-induced autocrine stimulation of fibroblast-derived collagenase/MMP-1 by interrelated loops of interleukin-1 and interleukin-6. Photochem. Photobiol., 1994, 59, p. 550–556.
63. WRIGHT, S. C., WEI, Q. S., KINDER, D. H. et al. Biochemical pathways of apoptosis: Nicotinamide adenine dinucleotide-deficient cells are resistant to tumor necrosis factor or ultraviolet light activation of the 24-kD apoptotc protease and DNA fragmentation. J. Exp. Med., 1996, 183, p. 463–471.
64. YIN, L., YAMAUCHI, R., TSUJI, T. et al. The expression of matrix metalloproteinase-1 mRNA induced by ultraviolet A1 (340–400nm) phototherapy is relevant to the glutathione (GSH) content in skin fibroblasts of systemic sclerosis. J. Dermatol., 2003, 30, p. 173–180.
65. YORK, N. R., JACOBE, H. T. UVA1 phototherapy: a review of mechanism and therapeutic application. Int. J. Dermatol., 2010, 49, p. 623–630.
66. YUKSEK, J., SEZER, E., KOSEOGLU, D. et al. Sclerodema treated with broad-band ultraviolet A phototherapy plus colchicine. Photodermatol. Photoimmunol. Photomed., 2010, 26, p. 257–260.
67. ZANE, C., LEALI, C., AIRO, P. et al.”High-dose” UVA1 tharapy of widespread plaque-type, nodular, and erythrodermic mycosis fungoides. J. Am. Acad. Dermatol., 2001, 44, p. 629–633.
68. ZIEMER, M., THIELE, J. J., GRUHN, B., ELSNER, P. Chronic cutaneous graft-versus-host disease in two children responds to UVA1 therapy: Improvement of skin lesions, joint mobility, and quality of life. J. Am. Acad. Dermatol., 2004, 51, p. 318–319.
Labels
Dermatology & STDs Paediatric dermatology & STDsArticle was published in
Czech-Slovak Dermatology
2013 Issue 4
Most read in this issue
- Nail surgery: Introduction, Review on Surgical Techniques and Our Experience in Selected Nail Diseases
- Dermatosurgery and its Crucial Position in the Field of Dermatology and Venereology
- Rare Form of Tinea capitis Profunda Caused by Trichophyton tonsurans in Child
- UVA1 in the Management of Dermatoses