Treatment Of Polymorphous Light Eruption Research Articles

光硬化治疗多形性日光疹的免疫机制及临床应用

Ultraviolet light hardening therapy is an effective method for the treatment of polymorphic light eruption (PLE) . Recent studies have shown that narrow-band ultraviolet B (NB-UVB) is effective and safe for the prevention of recurrence of PLE. However, its treatment mechanisms still need further elucidation, and clinical studies with large sample size are needed for long-term tracking and assessment of initial dose of photohardening, dose-addition principle, treatment frequency and maintenance treatment protocols, in order to confirm the clinical application value of ultraviolet light photohardening therapy. Key words: Ultraviolet therapy; Polymorphic light eruption; Photohardening; Immunological mechanism; Clinical application

Therapeutic effects of hydroxychloroquine combined with butyli flufenamatum ointment and other drugs for the treatment of polymorphous light eruption: a comparison study

Objective To evaluate the efficacy and safety of hydroxychloroquine combined with butyli flufenamatum ointment and other drugs for the treatment of polymorphous light eruption (PLE). Methods A total of 48 patients with PLE were randomly and equally classified into group 1 and group 2. Both groups took hydroxychloroquine 200 mg twice a day and loratadine 10 mg per day for the initial 4 weeks, then took hydroxychloroquine 100 mg twice a day alone for another 4 weeks. Group 1 also topically applied butyli flufenamatum ointment twice a day during the 8 weeks, while group 2 applied mometasone furoate cream twice a day for the first 2 weeks followed by butyli flufenamatum ointment twice a day for another 6 weeks. Each treatment cycle lasted 2 weeks, and both groups received 4 cycles of treatment. Patients were evaluated for the response rate at the end of each cycle, and for the total symptom score and erythema score before and after the 8-week treatment. Statistical analysis was carried out using t test, chi-square test, Fisher's exact test and repeated-measures analysis of variance with the SPSS17.0 software. Results On day 14, 28, 42 and 56, the total score improved in 0, 3, 12 and 19 patients in group 1 respectively, and in 1, 4, 12 and 20 patients in group 2 respectively; the erythema score improved in 1, 5, 13 and 18 patients in group 1 respectively, and in 0, 5, 11 and 17 patients in group 2 respectively. No significant difference was observed between the two groups in response rates at any of the above four time points (P > 0.05). Both the total score and erythema score significantly decreased after the 8-week treatment in both groups compared with the pretreatment scores (both P < 0.05). No serious adverse reaction was observed in either of the two groups. Conclusions Hydroxychloroquine combined with loratadine and butyli flufenamatum ointment shows high efficacy and safety for the treatment of PLE. Topical butyli flufenamatum ointment is highly effective for the treatment of PLE, especially for PLE cases mainly presenting with erythema. Key words: Hydroxychloroquine; Loratadine; Flufenamate acid; Treatment outcome; Comparative effectiveness research; Erythema; Polymorphic sun light eruption

Comparative study of efficacy and safety of hydroxychloroquine and chloroquine in polymorphic light eruption: A randomized, double-blind, multicentric study

Polymorphic light eruption is the most common photodermatosis characterized by nonscarring, pruritic, erythematous papules and plaques. To evaluate the efficacy and safety of hydroxychloroquine in comparison with chloroquine in patients suffering from polymorphic light eruption. This was a randomized, double-blind, comparative, multicentric study conducted at two centers. This study enrolled 68 (58.1%) males, 49 (41.8%) females whose ages ranged from 18-73 years and average weight was 57.89 +/- 8.27 kg. A total of 117 patients were enrolled in the study. Out of 117 patients, 63 patients were randomized to receive hydroxychloroquine tablets 200 mg twice daily for the first month and 200 mg once daily for the next month. Similarly, 54 patients were randomized to receive chloroquine tablets 250 mg twice daily for the first month and 250 mg once daily for the next month. The total duration of therapy for both the study arms was two months. The severity and frequency of burning, itching, erythema and scaling were evaluated at predetermined intervals (at baseline, after four, eight and 12 weeks of therapy). A significant reduction in severity scores for burning, itching and erythema was observed in patients treated with hydroxychloroquine than with chloroquine (P P = 0.229). The good to excellent response was reported by 68.9% of the patients who received hydroxychloroquine and by 63% of the patients who received chloroquine. The adverse events reported were mild to moderate and none of the patients reported any serious adverse events or ocular toxicity in this study. Hydroxychloroquine was found to be significantly more effective than chloroquine in the treatment of polymorphic light eruption and can be used safely in the dosage studied in such patients with little risk of ocular toxicity.

A simple method to assess severity of polymorphic light eruption.

The severity of polymorphic light eruption (PLE) is highly variable. The results of studies of the prevalence, pathogenesis, provocation and treatment of PLE may be highly dependent on the severity of disease in the patients studied. To produce a simple, valid and reproducible method to assess the severity of PLE. Eighty patients were asked about the PLE they had experienced during the preceding 12 months, using a standardized interview comprising 16 questions. The answer to each question received a score. A PLE Severity Index (PLESI) was formulated, consisting of 10 questions, with a possible total score of 2-100. The internal consistency of the PLESI (the extent to which the responses to different questions correlated with each other) was assessed by reliability analysis, using Cronbach's method. Twenty patients were re-interviewed 7-27 days later to assess the repeatability of the PLESI. The ease of provocation of PLE by exposure at 24-h intervals to solar-simulated radiation was assessed on a five-point scale in nine of the 80 subjects (the EOPSSR score). The value of Cronbach's alpha for the PLESI was 0.77. The distribution of the PLESI was consistent with a normal distribution, with a mean value of 52.7 and standard deviation of 19.4. It had a coefficient of repeatability of 20.1. The PLESI was positively correlated with EOPSSR (rs =0.69, P = 0.039) and the number of years since onset of PLE (rs = 0.25, P = 0.03). There was no association between the PLESI and the duration of persistence of the eruption after ceasing sun exposure (rs = 0.12, P = 0.30), the development of tolerance as summer progressed (rs = -0.14, P = 0.39), gender (P = 0.50) or skin type (P = 0.87). This study has (i) validated the concept that a single score can reflect disease severity in PLE by showing that the principal characteristics of the condition, including, for example, the extent of anatomical distribution and the ease of provocation of the eruption, correlate with each other; (ii) formulated the PLESI, which is a simple, valid and reproducible way of assessing disease severity; we suggest it could be used worldwide to determine the severity of PLE among patients enrolled in future PLE research; (iii) shown that the ease with which the eruption is provoked by solar-simulated radiation correlates with the severity of the condition; and (iv) shown that the duration of persistence of the eruption after sun exposure does not correlate with the severity of the condition.

Treatment of polymorphic light eruption.

Polymorphic light eruption (PLE) is a highly prevalent photosensitivity disorder, estimated to affect 11-21% people in temperate countries. Typically, PLE appears as a recurrent pruritic eruption comprising papules and/or vesicles and/or plaques, which occurs on photo-exposed skin sites following sun exposure, and which heals without scarring. Commoner in females, the aetiology is uncertain, although there is evidence of an immune basis. We perform a review of the prophylaxis and treatment of this condition. While sun protection, corticosteroids and desensitization phototherapy are the mainstays of management, a range of anti-inflammatory and immunomodulatory agents are reported.

Treatment of polymorphic light eruption

This review examines the available options for the treatment of polymorphic light eruption (PLE). Many patients do not present to dermatologists, but for those who do, usually with moderate to severe disease, appropriate treatment allows most of them to lead normal or near-normal lives during the summer months or on vacation in sunny climates. ( J Dermatol Treat (2000) 11: 195-199)

Preventive effect of an E. coli-filtrate (ColibiogenR) in polymorphous light eruption

During the administration of Colibiogen, a commercially available E. coli-filtrate, there was a significant (P less than 0.01) increase of the test dose of UVA necessary to elicit skin lesions in nine patients with polymorphous light eruptions. Control tests performed in the same manner without the drug indicate that this was due to treatment. Colibiogen appears to be of value in the treatment of polymorphous light eruption (PLE).

UVB phototherapy and photochemotherapy (PUVA) in the treatment of polymorphic light eruption and solar urticaria.

Forty subjects (36 with polymorphic light eruption and four with solar urticaria) were treated during the spring and early summer of the years 1982 to 1985 with either UVB phototherapy (a total of 54 treatment courses in subjects with polymorphic light eruption) or photochemotherapy (PUVA) (18 treatment courses in polymorphic light eruption and eight in solar urticaria patients). Both forms of prophylactic therapy were found to be effective in 90% of those with polymorphic light eruption, and PUVA in all those with solar urticaria. The optimum duration of treatment was 5 weeks. Adverse reactions, although common, were usually slight and rarely required alteration of the treatment regimen.

Polymorphous Light Eruption.

Polymorphous light eruption (PLE) is a common photodermatosis of unknown etiology. It afflicts mainly fair-skinned patients, with a preponderance of young females. There is, however, no absolute restriction as to age, sex, or race. Clinical variants include the papular, vesiculo-bullous, and hemorrhagic variety, as well as plaque, erythema multiforme-like, and insect bite (strophulus)-like types. Skin lesions appear only in certain exposed areas hours or a few days after intense sunshine, and are nearly always monomorphous in the same patient. The rash subsides spontaneously within several days without leaving scars. The histopathologic picture is characteristic and shows a perivascular lymphocytic infiltrate in the upper and middle corium with subepidermal edema, vacuolization of basal cells, and spongiosis in the lower epidermis. The most important differential diagnoses are solar urticaria, photosensitive erythema multiforme, and lupus erythematosus. The action spectrum of PLE is under debate. Reproduction of skin lesions has been reported with UVB, UVA, and, rarely, visible light, with UVA probably being the most effective part of the spectrum. More important than treatment of PLE is prophylaxis. UVA- and UVB-effective sunscreens are of some help. Phototherapy and especially photochemotherapy (psoralen + UVA; PUVA) offer effective ways to decrease light sensitivity. Systemic treatment with chloroquine or beta-carotene has been disappointing.

Treatment of polymorphous light eruption with nicotinamide: a pilot study.

In a pilot study, 42 patients suffering from polymorphous light eruption (PLE) were treated with oral nicotinamide, 3 g daily, for 2 weeks. Twenty-five patients remained free from lesions despite extensive sun exposure. We suggest that an abnormality in tryptophan metabolism is important in the aetiology of PLE, and that nicotinamide administration partially corrects this.

Treatment of polymorphous light eruption.

This study was designed in order to prove on a large-scale basis the efficacy of oral photochemotherapy (PUVA) in the prevention of polymorphous light eruption (PLE), to work out indication criteria for PUVA treatment of this disease, and to establish a simple method based on anamnestic data to differentiate UVA from UVB induced PLE. The results obtained in 106 PLE patients (85 UVA-, 21 UVB-induced) demonstrate that: 1) time consuming phototesting for determination of the disease's action spectrum is unnecessary for practical purposes; 2) PUVA-induced tanning under routine conditions represents a potent prophylaxis even in severe cases of PLE; and 3) topical sunscreens ("sunblockers") in the majority of cases are sufficient to protect UVB-promoted PLE, but fail in UVA-induced disease. PUVA thus seems the treatment of choice only in UVA-mediated PLE, the action spectrum of the disease at least in most cases being easily discovered from certain anamnestic data.

Hydroxychloroquine treatment of polymorphic light eruption

Hydroxychloroquine treatment of polymorphic light eruption

Comparison of PUVA and beta-carotene in the treatment of polymorphous light eruption

Therapy with oral psoralen photochemotherapy (PUVA) and oral beta-carotene was compared in 29 patients with polymorphous light eruption. Complete remission occurred in 90% (9/10) of those treated with PUVA and in 32% (6/19) treated with beta-carotene. In the six patients who were treated in consecutive years with both modalities all had remissions with PUVA while only two had remissions with beta-carotene.

The use of amodiaquin (camoquin) in the treatment of polymorphous light eruption.

The antimalarial drugs quinacrine (Atabrine), chloroquine (Aralen), and hydroxychloroquine (Plaquenil) are effective agents for the prevention and treatment of polymorphous light eruption 1-6 and also for the treatment of discoid lupus erythematosus. 5,7 A new antimalarial compound, amodiaquin (Camoquin), recently has been reported to be equally valuable in the treatment of discoid lupus erythematosus. 8,9 The present study was done to evaluate the effectiveness of this drug in the treatment and suppression of polymorphous light eruption. Nine patients with a history of recurrent prurigo and plaque-like forms of polymorphous light eruption were studied. These patients had had recurrences of their sunlight-induced eruption each summer, for periods ranging from 6 to 23 years. The eruption had been suppressed in eight of the nine patients during the preceding three summers (1953-1955) by chloroquine. The patients were not given suppressive antimalarial therapy during the spring and early summer of 1956 and were