PUVA Research Articles

Narrowband Ultraviolet B Phototherapy for Generalized Granuloma Annulare: Real-Life Experience and Review of the Literature.

Generalized granuloma annulare (GA) is an uncommon noninfectious granulomatous dermatitis. Phototherapy is often considered first-line therapy, with more evidence for psoralen ultraviolet A than narrowband ultraviolet B (NB-UVB). We aimed to evaluate the effectiveness and safety of NB-UVB in generalized GA and to review the literature. In this observational, retrospective study, 11 patients with generalized GA who received NB-UVB between 2013 and 2023 were evaluated. Data from the patients were obtained from the phototherapy unit and clinical follow-up forms. Eleven patients, 10 (90.9%) female and 1 (9.1%) male were included in the study. The mean age of the patients was 57.6 ± 7.9 years. The mean disease duration was 26.9 ± 27.9 weeks. Three (27.2%) of the patients had interstitial GA. All patients showed improvement: NB-UVB therapy resulted in complete response in 18.2% of the patients and partial response in 81.8%. The mean number of NB-UVB sessions was 36.4 ± 13.8. The mean cumulative dose was 37.1 ± 25.6 J/cm2. There was no significant difference in the mean number of sessions and cumulative dose according to clinical response (P > .05). NB-UVB was extremely well tolerated. After phototherapy, patients were followed for at least 6 months; no relapses were observed. NB-UVB is an effective and safe treatment option in generalized GA.

A retrospective study comparing PUVA therapy with and without maintenance therapy in patients with mycosis fungoides in a real‐word clinical practice

A retrospective study comparing PUVA therapy with and without maintenance therapy in patients with mycosis fungoides in a real‐word clinical practice

A-262 Targeting the hyperactive STAT3/5 Pathway in Cutaneous T-Cell Lymphoma: superior efficacy of multi-kinase inhibitor IQDMA over conventional PUVA therapy

A-262 Targeting the hyperactive STAT3/5 Pathway in Cutaneous T-Cell Lymphoma: superior efficacy of multi-kinase inhibitor IQDMA over conventional PUVA therapy

Impact of Fitzpatrick skin type on narrowband UVB therapy outcomes in cutaneous T-cell lymphoma: A retrospective analysis

Impact of Fitzpatrick skin type on narrowband UVB therapy outcomes in cutaneous T-cell lymphoma: A retrospective analysis

The efficacy of long-term psoralen plus ultraviolet A and low-dose interferon-a combination therapy in mycosis fungoides: A literature review.

Interferon (IFN)-a is often used in combination with psoralen plus ultraviolet A (PUVA) in patients with mycosis fungoides (MF) refractory to skin-targeted therapies in early or advanced stages. The main objective is to evaluate the effectiveness of combined PUVA and low-dose IFN-α-2a therapy in patients with early- and advanced-stage MF. Sixty-eight patients who received a combination of PUVA twice or thrice a week and INF-a 3 MU thrice a week for at least 3 months were reviewed retrospectively. The treatment response was evaluated as complete remission (CR), partial remission, stable disease, or progression. At the initiation, the majority of patients (66.2%) had early-stage disease. In 27.9% of cases, this was the initial treatment administered following the diagnosis of MF. The median duration of combination therapy was 11 months. Complete remission was achieved in 45.6% of the patients with an overall response rate of 60.3%. The mean duration of response was 5 months. Complete remission was statistically significantly higher in early-stage patients (p < .05). No statistically significant correlation was observed between CR and gender, histopathological features, or laboratory parameters. In patients with CR, 80% experienced relapse, significantly higher in early-stage patients (p < .05). However, there was no significant difference in disease-free survival between early and advanced stages (p > .05). The study results indicated that PUVA + low-dose INF-a combination therapy was more effective in the early stage than in the advanced stage. Additionally, there was a high relapse rate after the cessation of treatment in patients who achieved CR.

Combination of Fractional Carbon Di Oxide Laser with Narrow Band Ultravoilet B Therapy to induce repigmentation in stable resistant vitiligo- A split-lesional study

Context: Resistant vitiligo is challenging to treat and needs new therapeutic approaches such as combining fractional carbon dioxide (CO2) laser and narrow-band ultraviolet B (NB-UVB) therapy. Aims: The study aimed to determine the efficacy and safety of combining fractional CO2 laser and NB-UVB therapy to induce repigmentation in resistant localized vitiligo patches. Materials and Methods: In this open, prospective, split-lesional study, 40 stable resistant vitiligo patches in 30 patients were included and assessed. After an initial assessment, a few resistant patches of vitiligo were identified, and a symmetrical half of it was given two sessions of fractional CO2 laser 1 month apart, followed by NB-UVB sessions to both sides thrice weekly for 3 months. Photographs were taken at baseline and 12 weeks, and repigmentation responses were assessed by calculating the mean percentage of improvement and mean grade of pigmentation on the fractional CO2 laser with NB-UVB site (test) and the only NB-UVB site (control) and then compared using Wilcoxon signed-rank test, with significance determined by P value &lt;0.05. Results: The mean grade of pigmentation (1.8±0.88) and mean surface area improvement (8.40 ± 6.82 cm2) on the fractional CO2 laser with NB-UVB site (test) were statistically better than the mean grade of pigmentation (1.27 ± 0.71) and mean surface area improvement (5.37 ± 6.76 cm2) on the NB-UVB site. A better grade of pigmentation was noted over sun-protected areas with fractional CO2 and NB-UVB therapy, while NB-UVB therapy fared better in sun-exposed areas. Conclusions: Fractional CO2 laser with NB-UVB therapy is an effective treatment in resistant vitiligo patches, especially for sun-protected areas.

Tolerability of Narrow-band Ultraviolet-B Phototherapy for Different Dermatological Diseases in Relation to Co-medications.

Phototherapy is an efficient therapy for a variety of skin diseases. Various drugs can cause photosensitivity and impact tolerability of phototherapy. The tolerability was investigated of narrowband ultraviolet-B 311 nm therapy in dependence on the underlying disease and long-term co-medication. A total of 534 narrowband ultraviolet-B therapy courses were examined. Compared with psoriasis, adverse events were observed more frequently in eczematous diseases and, in some cases, other indications. About two-thirds of all courses were carried out in patients taking at least one photosensitising drug, according to the summaries of product characteristics. Phototherapy was more frequently associated with adverse events when medication was taken concomitantly. When considering the tolerability of phototherapy in dependence on individual substances or drug classes, no statistically significant result was shown after adjustment.

Phototoxicity in vitro and safety in vivo of the emulsion photosensitizer based on furanocoumarins of Heracleum sosnowskyi

The use of plants such as giant hogweed as raw materials for the manufacture of dosage forms has been little explored. In this study, we utilized furanocoumarins from the Heracleum sosnowskyi plant to create an experimental emulsion dosage form (EmFHS). The EmFHS was finely dispersed (481.8 nm ± 71.1 nm), shelf-stable, and contained predominantly 8-methoxypsoralen at a concentration of 1 mg/ml.Phototoxicity analysis of EmFHS for THP-1 cells under UV (365 nm) irradiation showed an IC50 of 19.1 µg/ml (24 h) and 6.3 µg/ml (48 h). In relation to spheroids (L929), EmFHS exhibited a phototoxic effect in the concentration range of 31.25–125 µg/ml8-MOP. A full phototoxic effect was observed 48 h after UV irradiation. The phototoxic effect of EmFHS in vitro was dose-dependent and comparable to the effect of emulsion synthetic 8-methoxypsoralen and chlorin e6 solution. EmFHS cytotoxicity was caused solely by UV radiation, and toxicity in the dark was minimal.EmFHS, administered at a dose of 3 mg/kg8-MOP, was found to be safe after a single intravenous administration to rats. It had a photosensitizing effect in the form of local photodermatitis when exposed to UV irradiation at a dose of 44 J/cm2.The biokinetics of emulsion furanocoumarins showed that the phototoxic effect of EmFHS is due to the high penetration ability of the emulsion into cells of spheroids. At the same time, it has a low degree of cumulation when administered intravenously.The obtained data suggest that EmFHS may be a promising treatment for PUVA therapy of various dermatological diseases. Additionally, the plant Heracleum sosnowskyi shows potential as a basis for creating new dosage forms with phototherapeutic effects.

Resistin in patients with psoriasis vulgaris during PUVA therapy

BACKGROUND: Currently, psoriasis represents a serious medical and social problem, and it is one of the most common chronic skin diseases. Over the past decades, special attention has been paid to the association of psoriasis with various diseases, such as cardiovascular diseases, inflammatory bowel diseases, depression, etc. Common comorbidities of psoriasis include metabolic syndrome or obesity. Resistin is one of the hormones produced by adipose tissue, the concentration of which increases markedly in patients with psoriasis. Resistin expression is induced by proinflammatory cytokines such as IL-1, IL-6, IL-12 and TNF-a. In turn, an increase in resistin levels leads to increased production of pro-inflammatory cytokines involved in the development of psoriasis, thereby promoting the recruitment of leukocytes during the inflammatory process leading to chronic inflammation. Taken together, the above changes may contribute to the development of metabolic syndrome in psoriasis. Among the effective methods of treating the disease, phototherapy methods (PUVA and UVB 311 nm) remain relevant. Considering these data, it is of interest to study the level of resistin in the serum of patients with psoriasis and its change after a course of PUVA.&#x0D; AIM: The aim of our study was to evaluate the serum resistin level in patients with psoriasis vulgaris before and after PUVA.&#x0D; MATERIALS AND METHODS: The study was conducted at the department of Skin and Venereology diseases at the Sechenov University in the period from June 2022 to November 2023. The study included 30 patients with psoriasis vulgaris of moderate severity (PASI 20), of whom there were 16 men and 14 women. The healthy control group included 20 participants (11 men and 9 women). All patients had blood drawn from a vein during hospitalization and after a course of PUVA. Healthy participants underwent a single blood draw from a vein.&#x0D; RESULTS: A noticeable decrease in the level of resistin in the blood serum was revealed after a course of PUVA in all patients with psoriasis compared to baseline values. In addition, after treatment, resistin levels approached the values recorded in healthy participants.&#x0D; CONCLUSION: Thus, our study allows us to consider resistin as a biological marker of the effectiveness of PUVA in the treatment of patients with psoriasis vulgaris, as well as a predictor of the occurrence of concomitant diseases in patients with psoriasis.

Does the risk of basal cell carcinoma increase in patients with psoriasis under treatment?

Psoriasis is a common, chronic, inflammatory disease. Although it mainly affects the skin, it has been associated with a large number of comorbidities. In addition to comorbidities such as depression and psoriatic arthritis, it is known that there is an increased prevalence of cancer in psoriasis patients. Skin cancers, particularly squamous cell carcinoma, have been associated with psoriasis. However, basal cell carcinoma data are limited. 346 psoriasis patients and 306 individuals were selected as the control group. There were no differences between the patient and control groups in terms of age and gender. The mean age of the psoriasis patients was 49.9 ± 15.8 years and the control group was 49.4 ± 13.4 years. Sociodemographic data of the patients were recorded. Pharmacological agents used in the treatment of psoriasis were included in the analysis. Disease severity was assessed by the psoriasis area severity index (PASI). In the physical examination of the patients, biopsies were taken from lesions suspicious for BCC. BCC diagnosis was made by histopathologically. The frequency of BCC was higher in psoriasis patients than in the control group (6.6% vs. 2.9%, p < .001). Advanced age (p < .001), smoking (p = .003), and arthritis (p < .001) were associated with BCC in psoriasis patients. However, there was no relationship between PASI and BCC (p = .142). Among the psoriasis treatments, only UV therapy was associated with BCC (p = .038). The frequency of PUVA (p < .001) and number of PUVA session (p = .010) was higher in psoriasis patients with BCC rather than NB-UVB. The frequency of BCC is increased in psoriasis patients. Psoriasis is associated with an increased risk of BCC, especially when treated with PUVA therapy for a long time.

PUVA photochemotherapy for the patients with atopic dermatitis

PUVA therapy (photochemotherapy) has anti-inflammatory, immunosuppressive and antiproliferative effects, which makes it possible to use it for the treatment of patients with chronic inflammatory skin diseases, including atopic dermatitis. At the same time, there are no summarized data on the results of PUVA therapy in patients with atopic dermatitis. In this regard, the effectiveness and safety of PUVA therapy in patients with atopic dermatitis was evaluated according to the scientific literature. Literature search was carried out using the keywords “atopic dermatitis” “PUVA therapy”, “photochemotherapy” in the databases of scientific publications PubMed and RSCI. The methods of irradiation used, as well as the effectiveness and safety of PUVA therapy in patients with atopic dermatitis were analyzed. 14 publications were found describing the results of 13 studies that evaluated the effectiveness of various methods of PUVA therapy in patients with atopic dermatitis — photochemotherapy with peroral use of a photosensitizer, photochemotherapy with its topical use, and PUVA baths. All studies have shown the effectiveness of PUVA therapy in patients with atopic dermatitis. Nevertheless, the limitations of using this method are noted — the possibility of the development of adverse events caused by ultraviolet irradiation and taking a photosensitizer, which requires a careful assessment of the benefit-risk ratio for the patient when prescribing PUVA therapy to patients with atopic dermatitis. According to the available literature data, PUVA therapy should be prescribed to adult patients with severe atopic dermatitis who have had insufficiently effective other therapy.

Multiple Bowen's disease due to long-term narrow-band ultraviolet B phototherapy: A case report and literature review.

By presenting a case study on multiple instances of Bowen's disease and the consistent use of narrow-band ultraviolet B (NB-UVB) phototherapy over a three-year period, our aim is to enhance the comprehension of domestic clinicians regarding the disease. Additionally, we seek to review existing literature, encouraging dermatologists to consider clinical secondary primary lesion diagnoses. Our approach involves analyzing a diagnosed case of multiple Bowen's disease, examining clinical manifestations, histopathology, imaging results, and treatment methods related to NB-UVB phototherapy. We aim to facilitate discussion and understanding through a comprehensive literature analysis. An elderly male with a 30-year history of psoriasis vulgaris initiated continuous NB-UVB therapy three years ago. A year later, he developed red patches and plaques with distinct borders and scaly surfaces on his face, trunk, lower extremities, and scrotum. Histopathological examination confirmed Bowen's disease. Treatment involved liquid nitrogen cryotherapy, with no recurrence observed during the one-year follow-up. This case highlights that Bowen's disease, typically solitary, can manifest as multiple instances, especially in individuals with a history of psoriasis vulgaris. While NB-UVB stands as the primary treatment for psoriasis vulgaris, caution is warranted due to the potential risk of skin tumor induction with prolonged high-dose usage. Clinicians should be vigilant in monitoring and assessing the long-term implications of such therapies.

New-insight UVB Treatment for Psoriasis Vulgaris in Vietnamese Patients.

Narrowband UVB (NBUVB) has recently been used in Vietnam for the treatment of psoriasis. However, there are no data on Vietnamese patients to adopt a uniform national protocol. This study aimed to establish an optimal NBUVB therapy for the treatment of psoriasis in Vietnamese patients. One hundred and twenty-two patients with psoriasis vulgaris were included. They were randomly allocated to two groups: the percentage dose (group 1, 62 patients) and the fixed dose (group 2, 60 patients). In group 1, the starting dose was 50% of the minimal erythema dose (MED) and the 10% increment dose adjusted in the next sessions. In group 2, the starting dose was based on Fitzpatrick skin types (fixed dose). Psoriasis area and severity index (PASI) was used to evaluate efficacy. More than 68% of the patients get PASI75 at session 36. Group 2 had significantly fewer sessions (20 ± 5 vs 25 ± 7, P- value = 0.0004) and lower cumulative dose than group 1 (14.1 ± 4.3 J/cm2 vs 18.0 ± 8.0 J/cm2, P- value = 0.0075) to achieve PASI75. Adverse effects were more common in group 2 than group 1, including burning sensation/erythema (43.33% vs 14.52%, P- value = 0.0009) and pruritus (75.00% vs 22.58%, P- value <0.0001). NBUVB therapy was safe and effective for Vietnamese psoriasis patients. Fixed doses produced a quicker clinical response with fewer sessions and lower cumulative doses. Adverse effects were mild in both groups and less noted for the MED-based dose. For the recommendation, a fixed dose should be applied for patients who have less concern about side effects, while a MED-based dose can be suitable for patients having conditions related to light sensitivity.

The effect of phototherapy on the dynamics of cytokine mRNA expression in the affected skin of patients with mycosis fungoides

Introduction. The role of the cytokine environment and immune deregulation in the pathogenesis of mycosis fungoides is unquestionable. Despite the fact that one of the methods of therapy for the early stages of mycosis fungoides is phototherapy (PUVA, UVB-311 nm), the effect of ultraviolet radiation on the lymphoproliferative substrate and pathogenetic links in mycosis fungoides has not been fully studied. Aim: to evaluate the effect of NB-UVB and PUVA therapy on the dynamics of cytokine mRNA expression in the affected skin of patients with mycosis fungoides. Material and Methods. A comparative non-randomized study of the cytokine mRNA expression dynamics in the affected skin and of the effectiveness of phototherapy was carried out in 28 patients with early stage of mycosis fungoides. The IL4, IL17A, IL17F, and IL22 mRNA expression was determined relative to the endogenous control GAPDH using the real-time reverse transcription PCR (RT-PCR). Evaluation of the effectiveness of NB-UVB and PUVA therapy was carried out using a BSA score (skin lesion area) and a modified severity-weighted assessment tool (mSWAT) score. Results. The study included 28 patients with early stages (IA–IIA) of mycosis fungoides; 9 patients received NB-UVB and 19 received PUVA therapy. 3.71-fold decrease in mSWAT (p &lt; 0.008), and 3-fold decrease in BSA scores (p &lt; 0.013) were observed in the NB-UVB-treated group. In the PUVA-treated group 3.47- and 2.19-fold lower scores of mSWAT (p &lt; 0.001) and BSA (p &lt; 0.001) were found. There were no significant differences in the expression of the studied cytokines in the NB-UVB-treated group; however, a significant 19 and 72 % increase in IL17F (p = 0.003) and IL22 (p = 0.021) was revealed afterPUVA therapy. Correlation analysis has shown a weak correlation between IL4 and IL17A (r = 0.43, p &lt; 0.027), and IL17F (r = 0.43, p &lt; 0.028) before the treatment. Under the influence of phototherapy, the formation of a cytokine network in the affected skin was observed: there were positive associations between IL4 and IL17A (r = 0.73, p &lt; 0.001), IL17F (r = 0.7, p &lt; 0.001) and IL22 (r = 0.43, p &lt; 0.024); IL17A and IL17F (r = 0.78, p &lt; 0.001); IL22 and IL17A (r = 0.63, p &lt; 0.001) and IL17F (r = 0.66, p &lt; 0.001). In the PUVA-treated group a high negative correlation between IL17A and mSWAT (r = -0.79415, p =0.010586), BSA (r = -0.75432, p = 0.018849) were found. Conclusion: The positive correlations between IL4, IL17A, IL17F and IL22 in the affected skin of patients with mycosis fungoides may underlie the positive effect of phototherapy.

Comparison of Efficacy of Localized Narrow-Band UVB Therapy Versus Localized PUVA Therapy in Chronic Hand Eczema

Comparison of Efficacy of Localized Narrow-Band UVB Therapy Versus Localized PUVA Therapy in Chronic Hand Eczema

Bazex Syndrome (Acrokeratosis Paraneoplastica): A Narrative Review of Pathogenesis, Clinical Manifestations, and Therapeutic Approaches.

Acrokeratosis paraneoplastica, also known as Bazex syndrome, is a relatively understudied yet clinically important dermatological condition that is inextricably associated with squamous cell carcinoma, predominantly of the upper respiratory and gastrointestinal tracts. Manifesting as unique psoriasis-like cutaneous lesions, Bazex syndrome functions as an early warning signal for underlying malignancies, underscoring the urgent need for its timely diagnosis and intervention. Notwithstanding its clinical relevance, the molecular and cellular mechanisms underpinning its pathogenesis are not fully understood. To address these gaps, this comprehensive literature review undertook a meticulous search across reputable databases such as EMBASE, MEDLINE/PubMed, and Web of Science. Our analysis ventures into multiple putative pathogenic pathways, including shifts in Th2 immune responses, aberrant secretion of growth factors, and immunological reactions to tumor-specific antigens. We also detail the clinical phenotypes of Bazex syndrome and their chronological linkage with the corresponding malignancies. Finally, the review evaluates the therapeutic effectiveness of various approaches, includingbut not limited totargeted cancer treatments, PUVA therapy, and topical corticosteroids. This synthesis aims to arm healthcare providers with a nuanced understanding of Bazex syndrome, facilitating more accurate diagnosis and tailored treatment paradigms.

On the issue of tolerability and safety of phototherapy in patients with psoriasis

BACKGROUND: Phototherapy using different wavelengths of the ultraviolet (UV) spectrum has been successfully used to treat a variety of dermatoses. Along with the positive effects of this intervention, there are both acute and long-term side effects that should be taken into account by the clinicians.&#x0D; AIM: to study the tolerability and safety of phototherapy (PUVA and UVB-311 nm) in patients with moderate to severe psoriasis.&#x0D; MATERIALS AND METHODS: There were 920 patients with psoriasis under our supervision from 2005 to 2021, of which 756 (82%) patients suffered from psoriasis vulgaris, 36 (4%) ― guttate psoriasis, 73 (8%) ― exudative psoriasis, 55 (6%) ― inverse psoriasis. 249/920 (27%) were diagnosed with psoriatic arthritis. Patients with moderate psoriasis received 311 nm UVB therapy (n=473), with severe psoriasis ― PUVA therapy (n=447).&#x0D; RESULTS: Out of 920 patients with psoriasis during the entire follow-up period, 385 (41.8%) noted one or more early side effects, which were short-lived and disappeared after the end of the PUVA course if the recommendations were followed. Among the early side effects that occurred during the procedures from taking a photosensitizer, the most common were transient nausea, vomiting, dizziness, headache, transient increase in hepatic transaminases. Side effects from the action of ultraviolet rays were reduced to the manifestation of itching, photodermatitis in the form of erythema, photodermatitis in the form of blisters, photoallergic reaction in the form of papular rash, dry skin, photoconjunctivitis, herpes simplex and even photoonycholysis. Patients treated with UVB-311 nm phototherapy complained on xerosis of the skin, itching, photodermatitis in the form of erythema, burning of the skin as early side effects. Long-term side effects in patients treated with PUVA therapy included lentigo (persistent mottled pigmentation), growth of melanocytic neoplasms, PUVA keratosis. In 11 (2.3%) patients with psoriasis who received UVB-311 nm therapy, new nevi appeared. In 42 (9.6%) patients treated with PUVA therapy and in 17 (3.8%) patients treated with UVB-311 nm, signs of photoaging were detected as well. In our study, only 1 (0.2%) patient was diagnosed with facial skin basal cell carcinoma, who received 5 courses of PUVA (119 procedures).&#x0D; CONCLUSION: Our study showed that side effects, especially long-term ones, were fewer and significantly less pronounced in patients treated with UVB-311 nm therapy. Comparing the benefits and risks of phototherapy sessions, we can conclude in favor of the effectiveness, good tolerability and safety of PUVA and UVB-311 nm therapy for the treatment of patients with moderate to severe psoriasis. A dose-dependent effect of photoaging was established: the more phototherapy courses were received, the more pronounced the signs of photoaging were, especially after PUVA therapy.

Comparative Study of Topical Latanoprost, Tacrolimus and Clobetasol Propionate in Combination with Microneedling and Narrow-Band Ultraviolet B in the Treatment of Non-Segmental Vitiligo

Abstract Background Vitiligo is a common skin disease in both sex. There are multiple options in the treatment of vitiligo but the response is unsatisfactory. In this comparative study we will study the effect of topical latanoprost, tacrolimus, clobetasol propionate in combination with microneedling and narrow-band ultraviolet B (NB-UVB) in the treatment of non-segmental vitiligo. Objective To evaluate and compare the efficacy and safety of topical latanoprost, tacrolimus, clobetasol propionate when combined with microneedling and NB-UVB in the treatment of nonsegmental vitiligo lesions. Patients and Methods This randomized self-controlled clinical trial included 30 vitiligo patients with at least 5 patches of stable vitiligo (150 patches), the patches were divided into five groups according to the treatment modality. The patients were recruited from the outpatient clinic of dermatology of Ain Shams University Hospital in the period from July 2019 to September 2020. Results Regarding safety of considered therapies, pain and erythema was reported with Microneedling + latanoprost and NB-UVB and Microneedling + topical tacrolimus and NB-UVB. Itching was associated with Microneedling + topical clobetasol propionate and NB-UVB while burning and dryness were associated with NB-UVB therapy. Conclusion Combination therapy in treatment of vitiligo showed higher efficiency compared to monotherapy. Microneedling + latanoprost and NB-UVB treatment combined therapy showed the maximal repigmentation in included patients followed by Microneedling + tacolimus and NB-UVB treatment. Monotherapy using NB-UVB showed minimal response when compared to other combination modalities.

Clinical effect of platelet-rich fibrin in combination with narrow-band ultraviolet B treatment in patients with small area deep burn wounds

Purpose: To investigate the influence of the combined use of platelet-rich fibrin and narrow-band UV B (NB-UVB) treatment on small-area deep burn wounds in patients.Methods: A total of 86 patients with small area deep burn wounds were assigned to control and study groups (n = 43/group). The control patients received routine drugs in combination with NB-UVB, while the study group was administered a combination of platelet-rich fibrin and NB-UVB therapy. Clinical efficacy indices were.Results: In the study group, the pre and post-treatment serum levels of TNF-α were 222.75 ± 4.86 and 65.42 ± 5.33 ng/L, while those in control group were 221.45 ± 6.84 and 114.68 ± 2.53 ng/L, respectively. The study group serum concentrations of IL-8 at pre- and post-treatment were 120.75 ± 4.53 ng/L and 45.39 ± 8.26 ng/L, while the control group values were 122.38 ± 2.65 and 79.52 ± 2.34 ng/L, respectively. After treatment, the serum levels of TNF-α and IL-8 were significantly down-regulated in both groups, relative to pre-treatment values, with lower levels in the study group (p &lt; 0.001). Wound healing time and frequency of dressing change in the study group were 20.6 ± 3.6 days and 7.1 ± 2.5 times, respectively, which were significantly lower than the corresponding control group values of 40.3 ± 10.7 days and 20.5 ± 5.6 times (p &lt; 0.001). There was a significantly higher incidence of scars in the control group than in study group (p &lt; 0.05).Conclusion: Combined use of platelet-rich fibrin and NB-UVB in the treatment of small area deep burn wounds lowers the serum levels of inflammatory factors. However, the combined therapy should be subjected to further clinical trials prior to application in clinical practice.

Bath psoralen plus ultraviolet-A photochemotherapy for chronic graft-versus-host disease: a retrospective cohort study.

Chronic graft-versus-host disease is a severe complication of allogeneic stem cell and bone marrow transplantation. First-line immunosuppressive agents, such as steroids, are used to prevent this disease; however, they have multiple side effects. Therefore, bath psoralen plus ultraviolet-A (PUVA) is an alternative second-line treatment. This study aimed to evaluate the clinical efficacy of bath PUVA for managing chronic graft-versus-host disease. This retrospective, case-control study included 14 patients with extensive cutaneous chronic graft-versus-host disease, resistant to systemic corticosteroid, treated with bath PUVA. Major and partial responses were defined as clinical improvements of >70% and 50-70%, respectively. We analyzed the graft-versus-host disease clinical presentation and timing after allogeneic stem cell and bone marrow transplantation, bath PUVA doses, background diseases, additional treatments, and adverse effects. We observed eight major (three lichenoid and five sclerodermatoid) and six partial (three lichenoid and three sclerodermatoid) responses after a mean of 28 treatment sessions. After 6 to 25 months, four of the eight patients with sclerodermatoid lesions and all those with lichenoid lesions experienced relapse but responded to additional treatment cycles. Bath PUVA is well-tolerated and effective for extensive cutaneous chronic graft-versus-host disease. It allows rapid tapering of adjuvant immunosuppressants; however, most patients require prolonged maintenance phototherapy.