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At least 73 records · Page 4Linked to original sources
PubMed1980

Inhibition of delayed hypersensitivity reaction in skin (DNCB test) by 8-methoxypsoralen photochemotherapy. Possible basis for pseudo-promoting action in skin carcinogenesis?

Fifty-five of a hundred and two subjects undergoing photochemotherapy with 8-methoxypsoralen and near ultraviolet showed an abnormally low or undetectable delayed cellular hypersensitivity reaction in the skin as judged by the dinitrochlorobenzene test. It is suggested that photochemotherapy may act as a pseudo-promotor by blocking an immunologically based control process in the skin so allowing the relatively rapid appearance of squamous skin tumours, documented elsewhere, in individuals whose skin already contains a population of potentially tumorous cells. Immune surveillance of a kind may thus operate in human skin. Impairment of delayed cellular hypersensitivity to dinitrochlorobenzene was more likely to occur with more intensive treatments and in patients with less skin pigmentation.

Adolescent↗
PubMed1980

Toxic hepatitis from oral methoxsalen photochemotherapy (PUVA).

A 59-year-old white woman with long-standing psoriasis, who had a damaged liver from methotrexate, developed a toxic hepatitis while on oral methoxsalen photochemotherapy (PUVA). Fever and marked elevation of liver enzymes occurred after the fifteenth PUVA treatment and spontaneously returned to normal within 5 days. One week later, following the next PUVA treatment, the same toxic hepatitis developed and again spontaneously resolved. Topical methoxsalen photochemotherapy with ultraviolet A (UVA) did not produce the toxic hepatitis and provided a suppression of the psoriasis on a maintenance basis.

Administration, Oral↗
PubMed1984

Spectral power distributions of radiation sources used in phototherapy and photochemotherapy.

Much attention is focused on the amount of radiant energy emitted by treatment systems used in phototherapy and photochemotherapy; however, another important property of a radiation source, the spectral power distribution (SPD), has often been ignored. Measurement of the SPDs of various radiation sources produced unexpected findings. The SPDs of fluorescent bulbs promoted specifically for use in psoralen and ultraviolet A (PUVA) therapy was fairly uniform. However, of three blacklight bulbs that also may be used for PUVA therapy, each had a different SPD, and one of these bulbs emitted more than 90% of its energy in the ultraviolet (UV) wave band at wavelengths greater than 360 nm. The wavelengths emitted by sunlamp fluorescent bulbs and an Alpine UV lamp, both of which are used for phototherapy, were predominantly less than 320 nm. A fluorescent bulb recently introduced for phototherapy had an SPD that was different from that of a PUVA bulb and from that of a sunlamp bulb, with a high emission in the 300- to 340-nm wave band. These findings indicate that consideration of both the SPD and the irradiance of a radiation source is necessary to determine its suitability for phototherapy or photochemotherapy.

Photochemotherapy↗
PubMed1999

Half-side comparison of erythemogenic versus suberythemogenic UVA doses in oral photochemotherapy of psoriasis.

BACKGROUND: Early American and European multicenter trials on the efficacy of photochemotherapy (PUVA) for psoriasis have clearly shown that the treatment protocol has a crucial impact on the cumulative UVA dose required for clearing patients. Most, if not all, treatment protocols rely on the PUVA-induced erythema as a guideline for UVA dosimetry. OBJECTIVE: Our aim was to investigate whether phototoxic erythema is integral to an optimized PUVA protocol or reflects an unnecessary overexposure of patients. METHODS: A standard high-dose UVA regimen using minimal phototoxic doses (MPD) was compared against two different low-dose regimens. To this purpose a bilateral comparison study was performed on 31 patients and divided in two parts. In the first trial on 14 patients, half of each patient's body was irradiated at each visit with 1 MPD, whereas the other half received only two thirds of the MPD. In the second trial on 17 patients treatment with 1 MPD was compared against treatment with one half of the MPD. RESULTS: A total of 27 patients (12 patients in the first trial, 15 patients in the second trial) completed the study. In both trials the suberythemogenic doses were therapeutically as effective as the minimal phototoxic doses. CONCLUSION: We conclude that PUVA-induced erythema is not a prerequisite for effective psoriasis treatment and that a low-dose UVA regimen is a promising approach to increase the short- and long-term safety of photochemotherapy.

Administration, Oral↗
PubMed1999

Phototherapy and photochemotherapy: an update.

Three types of phototherapy and 2 forms of photochemotherapy are now available for treatment of more than 40 diseases of the skin. Broadband ultraviolet B (UVB) phototherapy and oral psoralen photochemotherapy (PUVA) therapy are most widely available while there has been increased interest in topical PUVA therapy. Narrow-band UVB phototherapy and UVA-1 phototherapy offer potential for the future.

Humans↗
PubMed2002

Extracorporeal photochemotherapy--the Columbia Presbyterian experience.

BACKGROUND: Cutaneous T Cell Lymphoma (CTCL) is a lymphoma of skin homing usually CD4 + lymphocytes. There are numerous treatments available both for the early as well as the more advanced stages of the disease. Extracorporeal photochemotherapy is a well-accepted form of treating CTCL. The purpose of our study was to review the experience of treating 20 CTCL patients with extracorporeal photochemotherapy (ECP) at Columbia Presbyterian Medical Center over a seven-year period. METHODS: The study was conducted as a retrospective chart review of these 20 patients. Summarized demographic characteristics included age at diagnosis, gender, and race. We analyzed the overall response by categorizing patients as having complete response, partial response, stable disease, and progressive disease. We also analysed the predictive value for three factors: peripheral blood CD4 : CD8 (< 10, > 10), LDH level (normal, elevated), and erythrodermic status (erythrodermic or nonerythrodermic). The potential prognostic variables were evaluated for linear association with response using Mantel-Haenszel chi-square tests. All statistical tests were two-sided with alpha = 0.05. The tests were considered to be exploratory and no adjustments for multiple testing were made. RESULTS: There was a significant linear association between response and CD4 : CD8. Patients with a ratio < 10 were more likely to respond than patients with a ratio > 10. There was a marginally significant linear association between response and LDH level. Patients whose LDH was not elevated at the start of treatment, tended to have a better response to ECP compared to patients with an elevated LDH. There was a suggestion of an association between erythroderma and response although this was not statistically significant. The majority of patients with erythroderma were responders compared to the majority of non-erythrodermic patients who were non-responders. The treatment was well tolerated with minimal side-effects. CONCLUSION: Apparent predictors of good response to ECP include erythroderma, a relatively low (closer to normal) peripheral CD4 : CD8, and a normal LDH. This report confirms reports from other institutions indicating that CTCL patients who are erythrodermic with a relatively intact immune system are optimal candidates for ECP.

Adult↗
PubMed1997

[Photochemotherapy with indocyanine green in cutaneous metastases of rectal carcinoma].

HISTORY AND ADMISSION FINDINGS: Six weeks before admission of a 47-year-old man with known rectal carcinoma, small nodular metastases had occurred over the front of both his thighs. Examination showed many aggregatet cuti-color or livid nodes, diameter 0.5 cm. The patient's poor general condition excluded the usual palliative measures. TREATMENT AND COURSE: Photochemotherapy of the skin metastases with indocyanine green (ICG; absorption maximum 805 nm), a non-toxic dye approved for diagnostic purposes, was undertaken on a trial basis. The dye, being bound to plasma proteins, is retained in the intravacular space. Immediately after administration of the dye (2.5 mg/kg intravenously) the skin metastases were irradiated by diode laser (lambda = 805 nm, 100 J/cm2, 3 W/cm2, radiation diameter 2 cm). This necrosed the metastases and clinically as well as histologically resulted in their complete disappearance with scarring of the treated area. CONCLUSION: This case illustrates the effectiveness of photochemotherapy with ICG against solid skin tumours of increased microvascular density.

Humans↗
PubMed1979

Risk of cutaneous carcinoma in patients treated with oral methoxsalen photochemotherapy for psoriasis.

A 2.1-year prospective study of 1373 patients given oral 8-methoxypsoralen photochemotherapy for psoriasis revealed 30 patients with a total of 48 basal-cell and squamous-cell carcinomas. The observed incidence of cutaneous carcinoma was 2.63 (95 per cent confidence limits = 1.91 to 3.90) times that expected for an age, sex and geographically matched population. Relative risk to patients with history of ionizing radiation was 3.68 (99 per cent confidence limits, 2.42 to 8.69). Patients with a previous cutaneous carcinoma had a relative risk of 10.22 (99 per cent confidence limits, 4.78 to 37.08). A higher than expected proportion of squamous-cell carcinomas and an excess of squamous-cell carcinomas in areas not exposed to sun were seen. New patients with known histories of ionizing-radiation exposure or of skin tumors should be given 8-methyoxypsoralen photochemotherapy only if they understand the risks and have disabling psoriasis untreatable by other means.

Administration, Oral↗
PubMed1993

Phototherapy, photochemotherapy, and bone marrow transplantation.

Recent preclinical and clinical investigations indicate that phototherapy and photochemotherapy may have applications that go far beyond their "traditional" roles in the treatment of skin disorders, selected solid tumors, and neonatal hyperbilirubinemia. Bone marrow transplantation is one area that may benefit substantially from these new developments. This review focuses on new applications of phototherapy and photochemotherapy that pertain to the inactivation of tumor cells in autologous bone marrow grafts, the prevention and treatment of acute and chronic graft-versus-host disease, the prevention of transfusion-induced allosensitization and graft rejection, and the inactivation of pathogenic viruses and parasites in bone marrow grafts and blood products.

Animals↗
PubMed1984

Xerodermoid induced by photochemotherapy.

Photochemotherapy induces alterations in the skin that resemble those in xeroderma pigmentosum. Acute responses may be distinguished from late, chronic, and delayed responses to PUVA. All of the types of cells present in the skin are affected by photochemotherapy. The structure of the epidermis and of the superficial dermis are altered and, possibly as a consequence, neoplasms may ensue.

Bibliographies as Topic↗
PubMed1990

Treatment of cutaneous T-cell lymphomas (CTCL) with extracorporeal photochemotherapy--preliminary report.

Since August of 1988, we have treated seven CTCL patients with extracorporeal photochemotherapy, including two with tumor-stage mycosis fungoides (MF) showing mucinous degeneration, two with plaque-stage MF, and two with erythrodermatous MF. One was withdrawn just after the first trial. For each patient, the phenotypes of peripheral blood lymphocytes were analyzed by flow cytometry in terms of the percentages of OKT11, OKT3, OKT4, Leu9, OKT8, B1, Tac, OKT9, OKIa1, Leu7, Leu3a/4B4, and Leu3a/2H4 cells. These parameters were compared with the clinical responses according to skin score. The two patients with tumors died, but the five patients without tumors did not. Three of the 6 patients responded to the treatment. Side effects that are often associated with standard chemotherapy, such as bone marrow suppression, gastrointestinal symptoms and hair loss, were not observed. One cardiovascular event (1 patient) occurred. No significant changes in T-cell subsets were seen during the course of therapy. These preliminary data suggest that extracorporeal photochemotherapy may be effective for CTCL other than tumor-stage MF.

Adult↗
PubMed1978

Oral photochemotherapy in the treatment of lichen planus (LP). Clinical results, histological and ultrastructural observations.

Seven patients with diffuse lichen planus were treated with oral photochemotherapy. Remission was effected in 6 cases. The only failure may be attributable to a low UVA dose. Histological examination after treatment showed disappearance of the superficial dermal lymphocytic infiltrate. Ultrastructural study revealed nuclear alterations of keratinocytes and nuclear and cytoplasmic changes in superficial dermal cells. Various theories concerning the mode of action of photochemotherapy in lichen planus are discussed in the light of these observations.

Adult↗
PubMed1980

Photochemotherapy and topical nitrogen mustard in the treatment of mycosis fungoides.

Eight patients with mycosis fungoides limited to the skin have been treated with either topical nitrogen mustard alone or in combination with photochemotherapy. This regime does not prevent contact sensitization to nitrogen mustard but will clear sanctuary sites of disease which may develop when photochemotherapy is used alone.

Administration, Topical↗
PubMed1991

Extracorporeal photochemotherapy in the treatment of cutaneous T-cell lymphoma. Complexity of objective evaluation.

The term cutaneous T-cell lymphoma (CTCL) encompasses the spectrum of diseases characterized by a monoclonal proliferation of malignant T lymphocytes predominantly of the mature T-helper cell type. These include mycosis fungoides, which is usually localized to the skin for many years, and the Sezary syndrome, the leukemic variant in which characteristic, bizarre lymphatic cells with deeply indented or cerebriform nuclei, the Sezary cells, infiltrate lymph glands and internal organs such as the spleen, liver, lungs, heart, and bone marrow. The condition is more common in men after their fourth decade. The treatment of CTCL varies depending on the stage of the disease. The skin of the patient is the primary index of effectiveness of therapy. Options range from topical steroids, topical nitrogen mustard, X-irradiation, electron beam irradiation, and 8-methoxypsoralen (8-MOP) combined with ultraviolet A photochemotherapy (PUVA), to leukapheresis and systemic chemotherapy. More recently, extracorporeal photochemotherapy (ECPC) has been introduced. The safety and efficacy of this modality is further investigated in six patients who fulfilled the criteria of diagnosis of CTCL. The problems encountered in objectively evaluating the clinical responses in the patients are outlined and improvements in the protocol to overcome these are suggested. The proposed mechanism of action is an immunostimulatory one and a procedure that is relatively free from side effects; it offers promise as a potential treatment for a difficult cancer.

Aged↗
PubMed2005

Therapeutic and prophylactic effects of PUVA photochemotherapy on atopic dermatitis-like lesions in NC/Nga mice.

BACKGROUND: Psoralens and ultraviolet A radiation (PUVA) photochemotherapy has been used for severe cases of atopic dermatitis (AD). To understand the mechanisms of action is important for the choice of treatments. AD-like lesions can be induced experimentally in NC/Nga mice. OBJECTIVES: To evaluate clinically and histologically the therapeutic and prophylactic effects of PUVA on AD-like dermatitis using NC/Nga mice. METHODS: PUVA therapy was performed with intraperitoneal injection of 4 mg/kg of 8-methoxypsoralen (8-MOP) and 4 J/cm(2)-UVA irradiation before and after development of AD-like lesions in NC/Nga mice which had been maintained in a conventional room (Conv-NC/Nga mice). Clinical skin conditions were evaluated periodically by a clinical severity score defined. Lesions were histologically examined in haematoxylin-eosin or toluidine blue-stained sections. Plasma levels of total IgE were measured at various time points. RESULTS: In Conv-NC/Nga mice infested with mite, AD-like lesions started to develop at 8 week of age and thereafter increased in severity score. PUVA therapy at lower does than minimal phototoxic dose suppressed the development of dermatitis and was also therapeutically effective against established lesions. Proliferation of dermal mast cells in AD-like lesions was suppressed, but IgE hyperproduction was not changed after PUVA. CONCLUSIONS: These observations suggest that PUVA photochemotherapy reveals not only therapeutic but also prophylactic effects on human AD.

Animals↗
PubMed2005

Phototherapy and photochemotherapy of sclerosing skin diseases.

The treatment of sclerosing skin diseases [systemic sclerosis, localized scleroderma, lichen sclerosus et atrophicus, sclerodermoid graft-vs.-host disease, scleredema adultorum (Buschke), scleromyxedema and necrobiosis lipoidica] is difficult and remains a great challenge. Numerous treatments, some with potentially hazardous side effects, are currently used with only limited success. The introduction of phototherapy and photochemotherapy for sclerosing skin diseases has considerably enriched the therapeutic panel and proven useful in a number of sclerosing skin diseases especially in localized scleroderma. Two phototherapeutic modalitites are used for the treatment of sclerosing skin diseases, long-wave ultraviolet A and psoralen plus ultraviolet A (PUVA). This article reviews current knowledge about the application of phototherapy and photochemotherapy to various sclerosing skin disorders.

Humans↗
PubMed1987

Strategies for selective cancer photochemotherapy: antibody-targeted and selective carcinoma cell photolysis.

A principle objective in chemotherapy is the development of modalities capable of selectively destroying malignant cells while sparing normal tissues. One new approach to selective photochemotherapy, antibody-targeted photolysis (ATPL) uses photosensitizers (PS) coupled to monoclonal antibodies (MAbs) which bind to cell surface antigens on malignant cells. Selective destruction of human T leukemia cells (HBP-ALL) was accomplished by coupling the efficient PS chlorin e(6) to an anti-T cell MAb using dextran carriers. Conjugates with chlorin: MAb ratios of 30:1 retained > 85% MA b binding activity, and had a quantum yield for singlet oxygen production of 0.7 +/- 0.1, the same as that of free chlorin e(6). Cell killing was dependent on the doses of both MAb-PS and 630-670 nm light and occurred only in target cell populations which bound the MAb. On the order of 10(10) singlet oxygen molecules were necessary to kill a cell. A second approach to specific photochemotherapy, selective carcinoma cell photolysis (SCCP), relies on preferential accumulation of certain cationic PS by carcinoma cell mitochondria. We have evaluated several classes of cationic dyes, and in the case of N,N'-bis-(2-ethyl-1,3-dioxolane)-kryptocyanine (EDKC) and some of its analogs, have demonstrated highly selective killing of human squamous cell, bladder and colon carcinoma cells in vitro. In isolated mitochondria, EDKC uptake and fluorescence depended on membrane potential, and the dye specifically photosensitized damage to Complex I in the electron transport chain. N,N'-bis-(2-ethyl-1,3-dioxolane)-kryptocyanine and some of its analogs accumulated within subcutaneous xenografts of human tumors in nude mice with tumor:skin ratios > 8. Photoirradiation caused significant inhibition of tumor growth, without cutaneous phototoxicity.

Animals↗
PubMed1981

Relapse rate and long-term management of plaque psoriasis after treatment with photochemotherapy and dithranol.

The relapse rate of plaque psoriasis after initial clearing with the "Ingram" dithranol regimen or photochemotherapy was comparable when no maintenance treatment was given. It was estimated that psoriasis recurs to half of its pretreatment extent after about six months in half the patients. Maintenance treatment with photochemotherapy once a week or once every three weeks was useful in reducing the relapse rate. This study failed to show any statistical difference in relapse rates between these two maintenance schedules. If this finding turns out to be true over longer periods of study the maintenance schedule entailing treatment once every three weeks with its lower cumulative dose of long-wave ultraviolet light will clearly be preferable. The psoriasis in most patients was under better overall control with maintenance treatment than with intermittant clearing courses given when the extent of the psoriasis had become unacceptable to them. There was, however, a group of roughly one-fifth of patients who remained in satisfactory remission for over 16 months after initial clearing. Regular maintenance treatment was unnecessary in them. Much more information is needed on response to treatment in subgroups of patients to permit recognition from the start of which patients are likely to have long remission and which are not.

Adult↗