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At least 91 records · Page 5Linked to original sources
PubMed1991

Photopatch testing with different ultraviolet A sources can yield discrepant test results.

A photopatch test series consisting of 27 substances was tested in 81 patients with suspected photosensitivity disorders. Irradiation was performed using the following light sources: TL-K 40W/09 bulbs (UVA'; lambda max. at 355 nm), UVASUN 5000 (UVA''; lambda max. at 375 nm), and TL 20 W/12 bulbs (UVB; lambda max. at 315 nm). One day after applying 4 sets of the test substances (D1), one test series each was exposed to 10 J/cm2 of UVA' or UVA'', or a combination of 40 mJ/cm2 UVB and 10 J/cm2 UVA''; the fourth series was left nonirradiated (control). Photopatch test reactions (PPTR) were defined as positive if there was at least an indurated erythema on D3 or later between D3 and D21 (late-onset reactions) exclusively at the irradiated, but not at the control site. At least one positive PPTR was found in 35 patients (43%), 7 of whom exhibited late-onset reactions only; in 2 cases the tests could not be read because of skin irritation. On D3, there were 44 positive reactions with UVA', only 10 of which were also demonstrable with UVA''. Twenty-one late-onset PPTR were found with UVA' and 17 with UVA''. Late-onset reactions elicited by UVA' or UVA'' mostly were concordant; divergent positive or negative results were found only in a few cases. Compared with the results obtained with UVA' or UVA'' alone, combined irradiation with UVB and UVA'' occasionally led to divergent positive as well as negative results. When photopatch test results are interpreted, it should be considered that testing with different UVA sources may yield divergent results.

Adolescent↗
PubMed2000

Efficacy of short-course oral prednisolone in polymorphic light eruption: a randomized controlled trial.

BACKGROUND: Polymorphic light eruption (PLE) is the most common so-called idiopathic photosensitivity disorder and affects up to 15% of the population in the U.K.; brief courses of systemic steroids have been tried and anecdotally have apparently been dramatically effective in the treatment of acute attacks. OBJECTIVES: To assess the efficacy and safety of a short course of moderate-dose oral prednisolone used from the earliest onset of the eruption in the treatment of PLE. METHODS: The study was double-blind placebo-controlled, all patients being given both prednisolone and placebo, but randomized to take either one or the other from the earliest sign of onset of rash; if within 48 h there was no improvement, they transferred to the other medication. Each participant also applied a broad-spectrum, highly protective sunscreen 2-hourly during sun exposure, continued his or her usual degree of exposure after any development of PLE, and kept a diary noting details of the eruption, amount of exposure, weather conditions and any adverse events. Statistical analysis was performed by means of the non-parametric log rank test based on Kaplan-Meier plots and bootstrapped confidence intervals (CIs) for the means, using the time in days for the itch and rash to clear as the end-points. RESULTS: Twenty-one patients entered the study but only 10 required medication. Eight who took prednisolone first and remained on it or transferred to it from placebo all improved, with the itch settling fully within a mean 2.8 days of starting the prednisolone and the rash clearing by 4.2. In the two who took placebo first and remained on it, the itch took a mean 5.4 days to settle and the rash a mean 7.8. No patient who started with prednisolone changed to placebo. Thus, the prednisolone as randomized was better than placebo at settling both the itch (mean 2. 6 days less, CI 0.7-4.0, P = 0.015) and rash (mean 3.6 days less, CI 0.6-6.1, P = 0.036); only one patient experienced mild adverse effects of transient gastrointestinal upset and depressed mood. CONCLUSIONS: The acute eruption of PLE is likely to respond rapidly to short courses of prednisolone therapy given from the earliest onset of the condition, and the treatment is safe.

Acute Disease↗
PubMed2002

Associations of tumor necrosis factor alpha and HLA polymorphisms with adult dermatomyositis: implications for a unique pathogenesis.

We recently reported that the -308A tumor necrosis factor alpha promoter polymorphism is associated with the photosensitive disorder subacute cutaneous lupus erythematosus and mediates an exaggerated tumor necrosis factor alpha response to ultraviolet B. We now sought to examine the association of this polymorphism with adult dermatomyositis, a photosensitive disease that exhibits some features in common with subacute cutaneous lupus erythematosus. Fifty adult patients with dermatomyositis and 239 healthy, race-matched controls were examined for the -308A tumor necrosis factor alpha polymorphism and the more common -308G allele. The frequency of the -308A allele was 0.27 in the entire dermatomyositis group, versus 0.14 in the controls (p = 0.003, chi2 2 x 2 table). Caucasians were the only racial/ethnic group in our study large enough to allow separate statistical analysis (47 dermatomyositis, 223 controls). The frequency of the -308A allele was 0.26 for dermatomyositis and 0.14 for controls (p = 0.014). Caucasians are known to exhibit a linkage disequilibrium between -308A and HLA-DR3, which we previously found to be significantly enhanced in subacute cutaneous lupus erythematosus patients. In contrast, we now found no increase in the association of -308A and HLA-DR3 in Caucasians with dermatomyositis compared to controls. Consistent with this observation, the association of these two genes in dermatomyositis was significantly less than we previously reported in Caucasians with subacute cutaneous lupus erythematosus (p = 0.016). We conclude that the tumor necrosis factor -308A polymorphism is associated with dermatomyositis, which suggests a pathophysiologic contribution from ultraviolet-induced production of tumor necrosis factor alpha, similar to subacute cutaneous lupus erythematosus. The differences in linkage with HLA-DR3, as well as several divergent clinical features, indicate that there are also fundamental mechanistic differences between dermatomyositis and subacute cutaneous lupus erythematosus.

Adult↗
PubMed1996

Interleukin-15 expression by human endothelial cells: up-regulation by ultraviolet B and psoralen plus ultraviolet A treatment.

The purposes of the present study were to determine whether endothelial cells express IL-15 and to evaluate effects of ultraviolet B (UVB) and 8-methoxypsoralens plus UVA (PUVA) on such expression. Cultured human endothelial cells derived from dermis or umbilical veins were subjected to reverse transcriptase-polymerase chain reaction (RT-PCR) and immunoblot analyses for the detection of IL-15 mRNA and protein, respectively. Both dermal and umbilical vein endothelial cells were shown to express IL-15 mRNA and protein, and these markers were upregulated following UVB or PUVA treatment (but not by UVA or 8-methoxypsoralens alone). Also using RT-PCR, dermal and umbilical vein endothelial cells were shown to express IL-2R gamma c mRNA. These results expand the sources of IL-15 in skin to include keratinocytes, dermal fibroblasts, and now endothelial cells. That IL-15 from all three skin cells can be upregulated by UV treatment suggests a role for this cytokine in photosensitive disorders. Finally, the possibility of an autocrine effect of IL-15 on endothelial cells is raised by the expression of IL-2R gamma c in these cells.

Cells, Cultured↗
PubMed2000

Xeroderma pigmentosum variant heterozygotes show reduced levels of recovery of replicative DNA synthesis in the presence of caffeine after ultraviolet irradiation.

Patients with xeroderma pigmentosum variant show clinical photosensitivity, skin neoplasias induced by ultraviolet light, and defective postreplication repair, but normal nucleotide excision repair. We recently reported an alternative, simple method for the diagnosis of xeroderma pigmentosum variant that measures by autoradiography three cellular markers for DNA repair after ultraviolet irradiation: unscheduled DNA synthesis, recovery of RNA synthesis, and recovery of replicative DNA synthesis. Among hereditary photosensitive disorders, including other xeroderma pigmentosum groups, Cockayne syndrome, and a newly established ultraviolet-sensitive syndrome, only xeroderma pigmentosum variant cells exhibited normal unscheduled DNA synthesis, normal recovery of RNA synthesis, but reduced recovery of replicative DNA synthesis (51 +/- 6% the rate relative to normal controls). This reduction of recovery of replicative DNA synthesis was enhanced in the presence of a nontoxic level of caffeine to 36 +/- 5%. In this study we assess the cellular markers in two independent families that included two photosensitive patients that were identified as xeroderma pigmentosum variant. Cells from heterozygotic parents showed normal levels of unscheduled DNA synthesis, recovery of RNA synthesis, and recovery of replicative DNA synthesis, but reduced rates of recovery of replicative DNA synthesis in the presence of 1 mM caffeine (53 +/- 8% relative to the normal control). Furthermore, with a colony-forming assay, the cells showed normal survival by ultraviolet without caffeine, but slightly reduced survival by ultraviolet with 1 mM caffeine present. In one family, we confirmed inheritance of two heterozygous mis-sense mutations. One mutation is an A-->G transition at nucleotide 1840 that generates a K535E mis-sense mutation. Another mutation is an A-->C transversion at nucleotide 2003 that generates a K589 mis-sense mutation. Each of these mutations were absent in 52 unrelated Japanese individuals. These results suggest that xeroderma pigmentosum variant heterozygotes can be identified by their sensitivity to ultraviolet irradiation in the presence of nontoxic levels of caffeine.

Adult↗
PubMed2000

Photoreactivity of tiaprofenic acid and suprofen using pig skin as an ex vivo model.

The skin is repeatedly exposed to solar ultraviolet radiation. Photoreaction of drugs in the body may result in phototoxic or photoallergic side effects. Non-steroidal anti-inflammatory drugs, such as tiaprofenic acid (TPA) and the closely related isomer suprofen (SUP) are frequently associated with photosensitive disorders; they may mediate photosensitised damage to lipids, proteins and nucleic acids. Using ex vivo pig skin as a model, we investigated the photodegradation of TPA and SUP, and photobinding of these drugs to protein by means of HPLC analysis and drug-directed antibodies. Both with keratinocytes, which were first isolated from the pig skin and thereafter exposed to UVA and with keratinocytes which were isolated from pig skin after the skin was UVA exposed, time-dependent photodegradation of TPA and SUP was found, beside photoadduct formation to protein. The results of this work show that: (a) TPA and SUP were photodecomposed with similar efficiency; major photoproducts detected were decarboxytiaprofenic acid (DTPA) and decarboxysuprofen (DSUP), respectively. (b) Both drugs form photoadducts, as concluded from recognition by drug-specific antibodies. Pig skin appears to be a good model for studying the skin photosensitising potential of drugs.

Animals↗
PubMed1982

Solar urticaria. Clinical features and wavelength dependence.

Solar urticaria, an uncommon photosensitivity disorder, may be disabling for affected patients, especially those who react after short exposures to artificial or natural light. The spectrodermograph, a newly developed instrument, permits rapid, accurate determination of the action spectrum of solar urticaria. It consists of a xenon arc lamp with an emission dispersed into used to establish the wavelengths responsible for solar urticaria in 12 patients during the past four years. Knowledge of the wavelengths responsible for producing the urticarial reaction has implications for selecting appropriate therapy. The clinical course of these patients is also reviewed.

Adolescent↗
PubMed2004

mTHPC-mediated photodynamic therapy for early oral squamous cell carcinoma.

Surgery and radiotherapy are standard treatments for early oral squamous cell carcinoma, both resulting in good tumour control. However, neither of these modalities is without consequent functional or cosmetic impairment, and there are patients in whom both are contraindicated. Furthermore, there is a significant risk of metachronous tumours developing in the oral cavity, and salvage or retreatment with either surgery or radiotherapy poses difficulties. Photodynamic therapy (PDT) offers the potential for improved functional and cosmetic outcomes, while achieving comparable tumour control. We conducted an open-label, multicentre study to assess the efficacy and safety of meta-tetrahydroxyphenylchlorin (mTHPC) in patients with early oral cancer. One hundred twenty-one patients received intravenously administered mTHPC, followed 96 hr later by illumination of the tumour surface with 652 nm laser light. Of these patients, 114 were protocol compliant. A complete tumour response was achieved in 85% of protocol-compliant patients (97 of 114 patients). A complete response was maintained in 85% of responders at 1 year and in 77% at 2 years. One- and 2-year actuarial survival rates were 89% and 75%, respectively. In the opinion of the investigators, tumour clearance was accompanied by excellent cosmetic and functional results, without impact on the patients' performance status. Mild-to-moderate pain at the treatment site, a recognised side effect of PDT in the oral cavity, was reported by 82% of patients but was manageable with appropriate analgesia. Mild-to-moderate skin photosensitivity reactions were reported for 13% of patients. mTHPC offers an effective alternative treatment for early oral squamous cell carcinoma. It is associated with excellent functional and cosmetic results and can be used in conjunction with other standard therapies.

Adult↗
PubMed2001

Skin protection for photosensitized patients.

BACKGROUND AND OBJECTIVE: The goal of this study was to evaluate various creams for their capability to protect photosensitized skin from visible light. STUDY DESIGN/MATERIALS AND METHODS: Two cover creams and creams containing various combinations of Vaseline with TiO(2), ZnO, and Fe(2)O(3) were used to measure the reduced light transmission and the light absorption spectrum. In vitro and in vivo tests were performed to assess the protection from light by above mentioned compounds. RESULTS: The cover creams and the 50% TiO(2) cream showed similar efficacy in reducing light transmission, while the sunscreen was less efficient by a factor of 5. Cell protection by 25% TiO(2)+25% ZnO, TiO(2), or the cover creams was more efficient than protection by the sunscreen or other compounds. In vivo, the dark cover cream protected the skin by a factor of 3.4 better than the sunscreen. CONCLUSION: The dark cover cream has acceptable properties to protect photosensitized skin.

Absorption↗
PubMed2006

Endobronchial photodynamic therapy for lung cancer.

BACKGROUND AND OBJECTIVE: Endobronchial photodynamic therapy (PDT) is a minimally invasive technique for the palliation of major airway obstruction from lung cancer, and for the treatment of endobronchial microinvasive lung cancer. STUDY DESIGN: Results of reported clinical trials were compared, and the author's preliminary results with second generation photosensitizers were also reviewed. RESULTS: A review of the clinical experience with endobronchial PDT is provided. Potential advantages of PDT include the duration of palliation achieved through the delayed cellular effects of PDT within tumor. Side-effects from FDA-approved photosensitizer (Photofrin, Porfimer sodium, Axcan Scandipharm, Montreal, Quebec) include skin photosensitivity. HPPH (2-[1-hexyloxyethyl]-2 devinyl pyropheophorbide) is an example of a second-generation photosensitize that shows promise in the treatment of lung cancer, and appears to be free from significant skin photosensitivity. CONCLUSION: PDT is an effective tool for the palliation of endobronchial lung cancers which obstruct the central airways and is also effective for the treatment of central microinvasive carcinoma and carcinoma in situ of the central airways.

Airway Obstruction↗
PubMed2002

Role of clothes in sun protection.

Ultraviolet (UV) radiation is the carcinogenic factor in sunlight. Damage to skin cells from repeated UV exposure can lead to the development of skin cancer. Apart from avoidance of the sun, the most frequently used form of UV protection has been the application of sunscreens. The use of textiles as a means of sun protection has been underrated in previous educational campaigns, even though suitable clothing offers usually simple and effective broadband protection against the sun. Apart from skin cancer formation, exacerbation of photosensitive disorders and premature skin aging could be prevented by suitable UV-protective clothing. Nevertheless, several studies have recently shown that, contrary to popular opinion, some textiles provide only limited UV protection. It has been found that one-third of commercial summer clothing items provide a UV protection factor (UPF) less than 15. Given the increasing interest in sun protection, recreationally and occupationally, test methods and a rating scheme for clothing were needed that would ensure sufficient UV protection. Various textile parameters have an influence on the UPF of a finished garment. Important parameters are the fabric porosity, type, color, weight and thickness. The application of UV absorbers into the yarns significantly improves the UPF of a garment. Under the conditions of wear and use several factors can alter the UV-protective properties of a textile, e.g., stretch, wetness and laundering. The use of UV-blocking cloths can provide excellent protection against the hazards of sunlight; this is especially true for garments manufactured as UV-protective clothing. However, further educational efforts are necessary to change people's sun behavior and raise awareness for the use of adequate sun-protective clothing.

Humans↗