Low-dose UVA1 phototherapy in systemic sclerosis: effects on acrosclerosis - 24/08/11

Doi : 10.1016/j.jaad.2003.08.026

Alexander Kreuter, MD ^a, Frank Breuckmann, MD ^a,^⁎ , Andrea Uhle, MD ^a, Norbert Brockmeyer, MD ^a, Gregor von Kobyletzki, MD ^a, Marcus Freitag, MD ^a, Markus Stuecker, MD ^a, Klaus Hoffmann, MD ^a, Thilo Gambichler, MD ^a, Peter Altmeyer, MD ^a
^a Department of Dermatology and Allergology, Ruhr-University Bochum, Bochum, Germany

^*Reprint requests: Frank Breuckmann, MD, Department of Clinical and Experimental Dermatology, Ruhr-University Bochum, Gudrunstrasse 56, D-44791 Bochum, Germany.

Abstract

Background

Increased collagen synthesis, vascular damage, and T-lymphocytic infiltration contribute to the development of systemic sclerosis. Preliminary studies revealed the effectiveness of low-dose UVA1 phototherapy in acrosclerosis.

Objective

We sought to confirm data of a pilot study revealing the efficacy of low-dose UVA1 irradiation in acrosclerosis in a larger number of patients.

Methods

Symptoms of 18 patients receiving low-dose UVA1 phototherapy were evaluated clinically and biometrically in an open, nonrandomized study. A number of pretherapeutic and posttherapeutic biopsy specimens were tested immunohistochemically for matrix-metalloproteinase-1.

Results

UVA1 irradiation led to softening of former stiffness reflected by a significant decrease of the hand score, increase of total skin distension, and reduction of skin thickness. Posttherapeutically, matrix-metalloproteinase-1 immunolabeling revealed a significant dermal elevation of collagenase.

Conclusion

Low-dose UVA1 phototherapy is a capable treatment option for acrosclerosis. Its beneficial effect may be mediated by the induction of collagenases and a reduction of collagen deposition and cellular infiltration.

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