Successful treatment of microstomia with UVA1 phototherapy in systemic sclerosis

Abstract

To the Editor, The introduction of phototherapy has substantially changed the therapeutic response of localized scleroderma (LS). Systemic agents have been proposed for the treatment of LS, some with potential side effects and varying degrees of success. There is sufficient evidence in the literature to demonstrate that low dose (20 J/cm) and medium dose (50 J/cm) UVA1 phototherapy is beneficial in LS. The development of a metal halide lamp emitting high levels of UVA1 radiation (340–400 nm) was first described in 1981 (1), but the therapeutic potential for UVA1 phototherapy did not emerge until 1992 with the first successful report of treating patients for acute exacerbations of atopic dermatitis. It has now been shown to soften thickened plaques, increase skin elasticity and reduce lesional skin thickness in scleroderma (2–4). Recently (4), low-dose UVA1, mediumdose UVA1 and narrowband UVB phototherapy were compared demonstrating comparable efficacy of narrowband UVB and low-dose UVA1 but medium-dose UVA1 being more effective. In systemic sclerosis (SSc), studies of UVA1 are limited. Improvement has been documented in acrosclerosis in those patients with SSc (5). There is no documentation of treatment of other features of SSc by phototherapy in the literature. We describe a case of successful treatment of microstomia with UVA1 phototherapy in a patient with SSc. Case report