[Sunlight and ultraviolet radiation as causes of skin cancer].
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Biomedical subjects
Publications and source records attributed to G Swanbeck.
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The effect of PUVA therapy on pruritus, the skin mast cell population and histamine metabolism has been studied in 3 patients with urticaria pigmentosa and manifestations of systemic mastocytosis. Relief of itch was found concomitant with a significant decrease of the major histamine metabolite 1-methyl-4-imidazoleacetic acid in the urine. The decrease occurred during the first 2 mo after starting PUVA therapy and was sustained during an observation period of 3 mo after discontinuation of the treatment. At this time a reduction of the number of mast cells was found in skin biopsy specimens. No evidence of acute histamine release in association with PUVA treatment was obtained. These results suggest that this effective new treatment for urticaria pigmentosa reduces the histamine turnover in the skin by inhibiting mast cell proliferation.
12 patients with digital ischemia due to collagen vascular disease were treated with repeated infusions of low molecular weight dextran at intervals from 5 to 6 weeks. The patients were followed clinically and by capillary microscopy. In 5 patients an increased capillary blood flow was seen by capillary microscopy. The clinical changes consisted of a lower number of ulcers in 5 of 9 patients with ulcers and a reduction of cold intolerance in 8 of the 12 patients studied. 4 patients had no improvement at all from the treatment. A determination of dextran-reactive antibodies was also performed.
This review discusses the classification of generalized, hereditary forms of ichthyosis. The present state of knowledge of the mode of inheritance for the different forms of ichthyosis is briefly discussed in relation to genetic counselling. The different therapeutic principles are touched upon as well as other measures aimed at helping these patients to cope with some problems of everyday life.
The effect of PUVA treatment on the epidermal melanocyte system was studied in 24 skin biopsies from four male psoriatic patients. The patients had received 40 mg 8-methoxypsoralen and a phototoxic dose of UVA (2-12 joule/cm2), twice a week. Punch biopsies were taken from unaffected and psoriatic skin in the gluteal region before, and after three and nine treatments. The epidermal melanocytes were counted in dopa incubated split-skin preparations and the mitotic index of the keratinocytes was monitored as a control of the PUVA effect. The epidermal melanocyte number was essentially normal in non-treated psoriatic patients. During the PUVA treatment the melanin production and the DOPA activity of the melanocytes increased markedly. However, there was no significant change in the number of DOPA active melanocytes, either in the unaffected or the psoriatic skin. Thus, PUVA treatment is not necessarily associated with an increase in the number of active epidermal melanocytes.
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The HLA-A, -B -C typing of 100 bricklayers was performed. 50 bricklayers had developed contact allergy to chromium while 50 were healthy bricklayers. The distribution of HLA antigens were equal in the 2 groups.
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The correlation between serum concentration of methoxsalen (8-methoxypsoralen; 8-MOP) and phototoxic effect using long-wave ultraviolet light has been studied in 5 psoriatic patients. The maximum serum concentration occurred between 0.5 and 2 hr after oral administration of 0.6 mg/kg of methoxsalen. The lowest value for the minimum phototoxic dose (MPD), i.e., highest photosensitivity, was obtained between 1 and 2 hr. There was a significant negative correlation between the logarithm of the serum concentration and minimum phototoxic dose (MPD) (r = 0.780). Hence, the degree of photosensitivity appears to be related to the serum level of methoxsalen.
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The frequency of sister chromatid exchanges (SCE) was analysed in peripheral lymphocytes from patients receiving 8-methoxypsoralen (8-MOP) and longwave ultraviolet light (UVA) against psoriasis. The average SCE frequency in 14 patients after 3-10 weeks of clinical treatment did not differ statistically from that before treatment. UVA irradiation in vitro of blood from patients receiving 8-MOP caused a significant increase in the number of SCE. Such an increase was not observed after systemic administration of 8-MOP excluding UVA irradiation in vitro, nor after UVA irradiation in vitro in the absence of 8-MOP. Thus, the combination of oral 8-MOP administration and subsequent UVA irradiation in vitro promotes SCE in peripheral lymphocytes. However, this effect is not seen after clinical irradiation to the skin in vivo. The reason for this may be that the accumulated dose of UVA light in circulating lymphocytes, even after several weeks of clinical therapy, is not large enough to produce a significant amount of DNA damage leading to SCE, or else that DNA damage caused by the treatment is efficiency repaired during the intervals between treatments.
A method is given for the determination of 8-methoxypsoralen in human plasma at the low ng/ml level using gas chromatography with electron capture detection. 8-Methoxypsoralen was extracted from plasma with methylene chloride at pH 7.0. After addition of the internal standard, 8-butoxypsoralen, the psoralens were hydrolysed in sodium hydroxide and the aqueous phase was purified by extraction with methylene chloride and toluene. The aqueous phase was acidified and the re-lactonized psoralens were extracted with toluene and analysed. Some determinations of plasma levels of 8-methoxypsoralen after oral administration are presented.
Treatment of porphyria cutanea tarda (PCT) with chloroquine risks serious side-effects so we have combined it with phlebotomy. One to four venesections were performed before the administration of chloroquine in 10 PCT patients. Equally high excretion of urinary porphyrins was achieved but the side-effects were reduced. Chloroquine may be used as a provocative diagnostic test for patients with a questionably latent PCT but this is safe if phlebotomy is performed beforehand.
Human fibroblasts were exposed to tritium-labelled 8-methoxypsoralen (8-MOP) and longwave ultraviolet (UVA) light in vitro. The proportions of photochemically bound 8-MOP in the nucleus and cytoplasm were studied by autoradiography. The results show that UVA-irradiation of the cells in the presence of 8-MOP gives rise to a significant dose-dependent binding of 8-MOP in the cell nucleus.
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