ReportLow-dose UVA1 phototherapy in systemic sclerosis: effects on acrosclerosis☆
Section snippets
Patients
This open, nonrandomized study included 18 patients (1 man and 17 women), aged 39 to 81 years (median age: 58.5 years). Data of 8 patients have previously been reported in part.20 All patients (n = 18) had systemic sclerosis associated with diffuse cutaneous sclerosis, pronounced acral edema and sclerosis, and–in 4 patients–even piecemeal necrosis (average duration of disease: 6 years). In all, 15 patients were classified as limited, and 3 patients were characterized by the diffuse
Results
All 18 patients accepted and completed the applied low-dose UVA1 phototherapy. Except for a mild tanning, no acute side effects were observed. Posttherapeutic clinical benefit was reflected by a clear reduction of sclerosis. In 16 patients, palpation and inspection showed a marked softening of the formerly affected skin, an improvement of finger mobility, and—in 4 cases—an almost complete healing of the piecemeal necrosis (Fig 1, Fig 2). Only 2 patients showed no or just a slight improvement
Discussion
Scleroderma represents a rare chronic disorder of the connective tissue of unknown origin affecting various organs (eg, musculoskeletal, gastrointestinal, renal, cardiac, and pulmonary involvement) including the skin.23, 24, 25, 26 No causal therapy, either in limited or in diffuse sclerosis, has so far been achieved.27
High- and medium-dose UVA1 phototherapy have been used in the treatment of various T cell–derived skin diseases.28, 29, 30, 31 Low-dose UVA1 phototherapy has been shown to be
Acknowledgements
This work is part of the doctoral thesis of Andrea Uhle.
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Conflicts of interest: None identified.