Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Phototherapy

  • b phototherapy
  • intensive phototherapy
  • laser phototherapy
  • narrowband ultraviolet b phototherapy
  • narrowband uvb phototherapy
  • nb-uvb phototherapy
  • ultraviolet b phototherapy
  • uva1 phototherapy
  • uvb phototherapy

  • Selected Abstracts

    Phototherapy for neonatal jaundice,still in need of fine tuning

    ACTA PAEDIATRICA, Issue 7 2000
    TWR Hansen
    No abstract is available for this article. [source]

    Therapeutic Hotline: Treatment of prurigo nodularis and lichen simplex chronicus with gabapentin

    Gulsum Gencoglan
    ABSTRACT Psychocutaneous conditions are frequently encountered in dermatology practice. Prurigo nodularis and lichen simplex chronicus are two frustrating conditions that are classified in this category. They are often refractory to classical treatment with topical corticosteroids and antihistamines. Severe, generalized exacerbations require systemic therapy. Phototherapy, erythromycine, retinoids, cyclosporine, azathiopurine, naltrexone, and psychopharmacologic agents (pimozide, selective serotonin reuptake inhibitor antidepressants) were tried with some success. Here five cases with lichen simplex chronicus and four cases with prurigo nodularis, who responded well to gabapentin, are presented. [source]

    Cultured epithelial cells response to phototherapy with low intensity laser,

    Fernanda P. Eduardo PhD
    Abstract Background and Objectives Little is known about the intracellular response of epithelial cells to phototherapy. The aim of this in vitro study was to analyze the effect of phototherapy with low-energy lasers with different wavelengths and powers on cultured epithelial cell growth under different nutritional conditions. Study Design/Materials and Methods Epithelial cell cultures (Vero cell line) grown in nutritional deficit in culture medium supplemented with 2% fetal bovine serum (FBS) were irradiated with low-energy laser from one to three times with a GaAlAs laser (660 nm) and InGaAlP (780 nm), 40 and 70 mW, respectively, with 3 or 5 J/cm2. Cell growth was indirectly assessed by measuring the cell mitochondrial activity. Results Nonirradiated cell cultures grown in nutritional regular medium supplemented with 10% FBS produced higher cell growth than all cultures grown in nutritional deficit irradiated or not. The overall cell growth of cultures grown under nutritionally deficit conditions was significantly improved especially when irradiated with 780 nm for three times. Conclusions Phototherapy with the laser parameters tested increases epithelial cell growth rate for cells stressed by growth under nutritionally deficient states. This cell growth improvement is directly proportional to the number of irradiations; however, was not enough to reach the full cell growth potential rate of Vero epithelial cell line observed when growing under nutritional regular condition. Lasers Surg. Med. 39: 365,372, 2007. © 2007 Wiley-Liss, Inc. [source]

    Irradiation at 780 nm increases proliferation rate of osteoblasts independently of dexamethasone presence,

    Neusa A. Fujihara MSc
    Abstract Background and Objectives We have previously shown that phototherapy increases cell growth and impairs protein secretion of fibroblasts. Our objective was to study the effect of phototherapy on osteoblast-like cells in culture treated with dexamethasone. Study Design/Materials and Methods Rat calvaria osteoblast-like cells were previously treated or not with dexamethasone and then, they were irradiated or not with a GaAlAs diode laser (wavelength of 780 nm, 10 mW, 3 J/cm2). Adhesion, proliferation, and osteonectin synthesis were analyzed. Results Phototherapy increased the proliferation rate of cells independently of dexamethasone presence. Adhesion and osteonectin synthesis were not significantly influenced by laser and/or dexamethasone. Conclusions Based on the conditions of this study we concluded that phototherapy acts as a proliferative stimulus on osteoblast-like cells, even under the influence of dexamethasone. Thus, we suggest that phototherapy can be of importance as co-adjuvant in bone clinical manipulation in order to accelerate bone regeneration. Lasers Surg. Med. 38:332,336, 2006. © 2006 Wiley-Liss, Inc. [source]

    Vitamin D production in psoriasis patients increases less with narrowband than with broadband ultraviolet B phototherapy

    Amra Osmancevic
    Background: Phototherapy of psoriasis is an effective treatment. In addition to standard broadband ultraviolet radiation B (UVB), (280,320 nm), narrowband phototherapy (NBUVB) (monochromatic UV between 311 and 312 nm) has become an important treatment for psoriasis. The same wavelength range of UVB (290,315 nm) induces synthesis of vitamin D. The aim was to compare the effect of broadband with NBUVB therapy on vitamin D synthesis in patients with psoriasis. Methods: Sixty-eight Caucasian patients (17 women and 51 men) mean age 54.1 ± 16.0 years, with active plaque psoriasis, were treated with broadband UVB (n=26) or NBUVB (n=42) two to three times/week for 8,12 weeks. The serum concentrations of 25-hydroxyvitamin D (25(OH)D3), 1,25-dihydroxyvitamin D (1,25(OH)2D3), intact parathyroid hormone (PTH), calcium and creatinine were measured before the first exposure and after the last dose of radiation. Results: In broadband UVB treated patients, 25(OH)D3 increased from 37.9 ± 16.9 to 69.4 ± 19.7 ng/ml (P<0.0001) and in patients treated with NBUVB from 34.8 ± 11.9 to 55.3 ± 17.6 ng/ml (P<0.0001) and P=0.008 between the treatment groups. PTH decreased on broadband UVB (P<0.05). The serum concentrations of 1,25(OH)2D3, calcium or creatinine remained unaltered. Conclusion: Serum 25(OH)D3 in psoriasis patients increased less with NBUVB than with broadband UVB phototherapy. Psoriasis improved on both regimens. [source]

    Broadband targeted UVB phototherapy for localized vitiligo: a retrospective study

    Ahmet Akar
    Phototherapy with ultraviolet B (UVB) or PUVA has been used in the treatment of vitiligo for many years. The aim of this study was to analyze retrospectively the efficacy and safety of targeted broadband UVB phototherapy in patients with localized vitiligo. Thirty-two patients (14 male, 18 female), aged 18,65 years, were treated with Daavlin T500x High Dose Targeted Phototherapy System. Patients were treated twice or thrice weekly, totaling 20 to 60 sessions. Out of 32 total patients, only four patients (12.5%) showed visible repigmentation. In two patients, repigmentation was more than 75%. Other two patients showed mild repigmentation (less than 25%). All the lesions responsive to treatment were facial lesions. Mild adverse events recorded in 3 of 32 patients. Although safety of targeted broadband UVB phototherapy in the treatment of localized vitiligo is good, its therapeutic effectiveness is limited and depends on the locations of vitiligo lesions. [source]

    Phototherapy in the management of atopic dermatitis: a systematic review

    N. Bhavani Meduri
    Background/purpose: Atopic dermatitis (AD) is a common and extremely burdensome skin disorder with limited therapeutic options. Ultraviolet (UV) phototherapy is a well tolerated, efficacious treatment for AD, but its use is limited by a lack of guidelines in the optimal choice of modality and dosing. Given this deficit, we aim to develop suggestions for the treatment of AD with phototherapy by systematically reviewing the current medical literature. Methods: Data sources: All data sources were identified through searches of MEDLINE via the Ovid interface, the Cochrane Central Register of Controlled Trials, and a complementary manual literature search. Study selection: Studies selected for review met these inclusion criteria, as applied by multiple reviewers: controlled clinical trials of UV phototherapy in the management of AD in human subjects as reported in the English-language literature. Studies limited to hand dermatitis and studies in which subjects were allowed unmonitored use of topical corticosteroids or immunomodulators were excluded. Data extraction: Included studies were assessed by multiple independent observers who extracted and compiled the following data: number of patients, duration of treatment, cumulative doses of UV radiation, adverse effects, and study results. Data quality was assessed by comparing data sets and rechecking source materials if a discrepancy occurred. Results: Nine trials that met the inclusion criteria were identified. Three studies demonstrated that UVA1 is both faster and more efficacious than combined UVAB for treating acute AD. Two trials disclosed the advantages of medium dose (50 J/cm2) UVA1 for treating acute AD. Two trials revealed the superiority of combined UVAB in the management of chronic AD. Two additional studies demonstrated that narrow-band UVB is more effective than either broad-band UVA or UVA1 for managing chronic AD. Conclusion: On the basis of available evidence, the following suggestions can be made: phototherapy with medium-dose (50 J/cm2) UVA1, if available, should be used to control acute flares of AD while UVB modalities, specifically narrow-band UVB, should be used for the management of chronic AD. [source]

    Phototherapy and photochemotherapy of sclerosing skin diseases

    Michaela Brenner
    The treatment of sclerosing skin diseases [systemic sclerosis, localized scleroderma, lichen sclerosus et atrophicus, sclerodermoid graft-vs.-host disease, scleredema adultorum (Buschke), scleromyxedema and necrobiosis lipoidica] is difficult and remains a great challenge. Numerous treatments, some with potentially hazardous side effects, are currently used with only limited success. The introduction of phototherapy and photochemotherapy for sclerosing skin diseases has considerably enriched the therapeutic panel and proven useful in a number of sclerosing skin diseases especially in localized scleroderma. Two phototherapeutic modalitites are used for the treatment of sclerosing skin diseases, long-wave ultraviolet A and psoralen plus ultraviolet A (PUVA). This article reviews current knowledge about the application of phototherapy and photochemotherapy to various sclerosing skin disorders. [source]

    Minimal erythema dose after multiple UV exposures depends on pre-exposure skin pigmentation

    M. Henriksen
    Background/purpose: Phototherapy consists of multiple ultraviolet (UV) exposures. Most previous studies have focused on erythema following a single UV exposure in fair-skinned persons. Although it is well known that phototherapy lowers the daily UV-threshold dose for erythema in clinical practice, this is insufficiently documented under controlled experimental conditions. The purpose of this study was to quantify the change in the daily threshold for a dose specific erythema grade after 1,4 consecutive daily UV exposures. Methods: Forty-nine healthy volunteers (skin type II,V) with varying pigmentation quantified by skin reflectance. Two UV sources were used: a narrowband UVB (Philips TL01) and a Solar Simulator (Solar Light Co.). Just perceptible erythema after 24 h was chosen as the minimal erythema dose (+); besides + and ++ were assessed. Results: We found a positive and significant exponential relationship between skin pigmentation and UV dose to elicit a specific erythema grade on the back after 1,4 UV exposures. After repetitive UV exposures the UV dose had to be lowered more in dark-skinned persons compared with fair-skinned persons to elicit a certain erythema grade. This applied to both UV sources and all erythema grades. Conclusion: In the dark-skinned persons the daily UV dose after the 4 days UV exposure should be lowered by 40,50% to avoid burns compared with the single UV exposure. For the most fair-skinned persons essentially no reduction in the daily UV dose was needed. Our results indicate that the pre-exposure pigmentation level can guide the UV dosage in phototherapy. [source]

    Phototherapy and PUVA photochemotherapy in children

    S. A. Holme
    The use of phototherapy and photochemotherapy in children has been limited due to concerns over their long-term carcinogenic potential. Furthermore, the method of administration is disconcerting to some children, particularly as phototherapy treatment units are seldom rendered ,child-friendly'. Despite these reservations, ultra-violet therapies can be useful treatment options for children with selected dermatological conditions provided they are used under carefully controlled conditions. [source]

    Ninety-six points of light: phototherapy practices of members of The Photomedicine Society

    Colby C. Evans
    Background:,Phototherapy is an effective and relatively safe treatment for many skin diseases. Recent concern has focused on an apparent decline in phototherapy usage in the US. Objective:,To determine the current state of phototherapy as practiced globally. Methods:,Cross-sectional survey of members of the Photomedicine Society. Results:,Data derived from responses of 96 members showed all to have been in practice for more than five years, providing phototherapy within two years of completing residency. Usage of narrow-band ultraviolet B, ultraviolet A-1 (UVA-1), bath-psoralens plus UVA, and photodynamic therapy was markedly greater among phototherapists in Europe compared to their counterparts in North America and Asia. Conclusions:,Worldwide, there are fewer younger dermatologists who incorporate phototherapy in their practices. European phototherapists have led the world in usage of the newer phototherapy modalities. [source]

    Eosinophilic fasciitis treated with psoralen-ultraviolet A bath photochemotherapy

    R. Schiener
    Eosinophilic fasciitis is a rare disorder which can markedly affect the quality of life in individual patients. So far, no generally accepted and effective treatment modality has been available. Although the precise nature of eosinophilic fasciitis is still unknown, it is often regarded as a variant of localized scleroderma (morphoea). Phototherapy and photochemotherapy have been shown to be effective in the treatment of sclerodermatous skin lesions. We report a patient with eosinophilic fasciitis which was successfully treated with psoralen plus ultraviolet A bath photochemotherapy within 6 months. [source]

    Phototherapy of generalized prurigo nodularis

    E. Bruni
    No abstract is available for this article. [source]

    Combination of 308-nm xenon chloride excimer laser and topical calcipotriol in vitiligo

    SM Goldinger
    Abstract Background,, A large variety of therapeutic agents are being used for the treatment of vitiligo, but treatment remains a challenge. Recently, monochromatic phototherapies such as 311-nm narrowband ultraviolet B therapy and 308-nm xenon chloride excimer laser have been reported to be an effective and safe therapeutic option in children and adult patients with vitiligo. Single reports stipulate that the addition of topically applied calcipotriol to phototherapy increases its effectiveness. Objective, The purpose of the present pilot study was to determine if the addition of topical calcipotriol increases the efficacy of the 308-nm xenon chloride excimer in the treatment of vitiligo. Methods, Ten patients with vitiligo with essentially bilateral symmetrical lesions were enrolled in this prospective right/left comparative, single-blinded trial conducted over a 15-month period. All patients received 308-nm XeCl excimer laser therapy three times weekly. Calcipotriol ointment (Daivonex®) was applied to lesions on one side of the body twice daily. Results, After 24 treatments (8 weeks), nine patients were evaluated. Eight patients showed evidence of repigmentation on both body sides, with no significant difference between the body side treated with calcipotriol and excimer laser and the side treated with excimer laser alone. The mean repigmentation rate was 22.4% (1, 37%). Conclusion, The addition of calcipotriol ointment to 308-nm xenon chloride excimer laser phototherapy does not significantly enhance its efficacy. Small additive effects must be investigated in a larger trial. [source]

    Ultrastructural changes induced in cutaneous collagen by ultraviolet-A1 and psoralen plus ultraviolet A therapy in systemic sclerosis

    Noriyuki SAKAKIBARA
    ABSTRACT In the present study, we examined the ultrastructural alterations in collagen fibrils clinically softened by ultraviolet-A1 (UVA1, 340,400 nm) therapy and psoralen plus long-wave ultraviolet (PUVA) therapy and compared collagen fibril diameters in four patients with systemic sclerosis (SSc). In skin sclerosis, the dermis is compacted from the epidermal layer to the sweat glands, and the collagen bundles are thicker with decreased space between them. We obtained skin specimens before and after UVA1 or PUVA therapy, and compared cutaneous alterations in one diffuse-type patient and one limited-type patient following UVA1 therapy, and in two diffuse-type patients following PUVA treatment. Ultramicroscopic analysis revealed that UVA1 treatment decreased the diameter of the broad collagen fibrils, mainly in the upper reticular layer. PUVA induced similar alterations in the collagen fibrils, extending to the upper and middle reticular layers. PUVA therapy induced alterations in collagen fibril diameter in deeper layers than did UVA1 therapy, which might be related to the direct action of UV light and the depth of the light penetration. In three of four patients, collagen fibril diameter decreased, collagen fibril thickness equalized, and new, thin fibrils developed among the collagen fibrils, suggesting that collagen degradation and synthesis underlie the alterations induced by UVA1 and PUVA phototherapies. [source]

    Limiting light-induced lipid peroxidation and vitamin loss in infant parenteral nutrition by adding multivitamin preparations to Intralipid

    ACTA PAEDIATRICA, Issue 3 2001
    KM Silvers
    Parenteral lipids are susceptible to light-induced peroxidation, particularly under phototherapy. Ascorbic acid is protective. The aim of this study was to investigate whether dark delivery tubing and/or coadministration of multivitamin preparations could prevent peroxidation of Intralipid without undue vitamin loss. In experiments carried out on the benchtop, lipid peroxidation occurred in ambient light and was more extensive under phototherapy. Dark tubing decreased peroxide formation, but only by about 65%. In simulated clinical conditions in which solutions were pumped through standard clear or dark minibore plastic tubing, Intralipid accumulated lipid peroxides as measured by the FOX assay (280 ,M) or as triglyceride hydroperoxides (52 ,M). Multivitamin preparations (MVIP or Soluvit/Vitlipid) inhibited peroxide formation almost completely, and were fully protective when used with dark tubing. There was loss of riboflavin (65% from Soluvit and 35% from MVIP) in clear tubing but this was decreased to 18% and 11%, respectively, in dark tubing. Ascorbate loss was 20% (MVIP) and 50% (Soluvit) and only slightly less in dark tubing. Ascorbate loss was also seen in the absence of Intralipid and is due to riboflavin-induced photo-oxidation. Conclusion: Multivitamin preparations protect Intralipid against light-induced formation of lipid hydroperoxides, and administering multivitamins with Intralipid via dark delivery tubing provides a practical way of preventing peroxidation of the lipid while limiting vitamin loss. This procedure should be considered for routine use as well as with phototherapy. [source]

    Recurrence of kernicterus in term and near-term infants in Denmark

    ACTA PAEDIATRICA, Issue 10 2000
    F Ebbesen
    Classical acute bilirubin encephalopathy (kernicterus) in term and near-term infants had not been seen in Denmark for at least 20 y until 1994. From 1994 to 1998, however, six cases were diagnosed. Aetiology of the hyperbilirubinaemia was known in two infants; spherocytosis and galactosaemia, most likely known in two infants; possible A-O blood type immunization, and unknown in two infants. However, one of these last-mentioned infants had a gestational age of only 36 wk. The maximum plasma total bilirubin concentrations were 531,745 ,mol/L. The increase in the number of cases of kernicterus was considered to have been caused by: (i) a decreased awareness of the pathological signs, (ii) a change in the assessment of the risk of bilirubin encephalopathy, (iii) early discharge of the infants from the maternity ward, (iv) so-called breastfeeding-associated jaundice, (v) demonstration of bilirubin being an antioxidant, and (vi) difficulty in estimating the degree of jaundice in certain groups of immigrants. Accordingly, for prevention: (a) Attempt to change the healthcare workers' understanding of the risk of bilirubin encephalopathy, (b) give further instructions, both orally and in writing, to mothers before discharge from the maternity ward, (c) be more liberal in giving infant formula supplements, (d) conduct home visits by the community nurse at an earlier stage, (e) follow authorized guidelines for phototherapy and exchange transfusion, (f) lower plasma bilirubin concentration limits as an indication for phototherapy and exchange transfusion, (g) screen all term and near-term infants, and (h) measure the skin's yellow colour with a device that corrects for the skin's melanin content. Conclusions: Audit of the six cases presented indicates that measures are necessary in both the primary and secondary healthcare sectors if the risk of kernicterus is to be avoided. Screening may be considered, but in order to identify the problems it would first be reasonable to perform a larger prospective study in which audit is performed on all newborn infants, born at term and near-term, who develop a plasma bilirubin concentration above the exchange transfusion limit. [source]

    Patients with a major depressive episode responding to treatment with repetitive transcranial magnetic stimulation (rTMS) are resistant to the effects of rapid tryptophan depletion

    John P. O'Reardon M.D.
    Abstract Repetitive transcranial magnetic stimulation (rTMS) appears to be efficacious in the treatment of major depression based on the results of controlled studies, but little is known about its antidepressant mechanism of action. Mood sensitivity following rapid tryptophan depletion (RTD) has been demonstrated in depressed patients responding to SSRI antidepressants and phototherapy, but not in responders to electroconvulsive therapy (ECT). We sought to study the effects of RTD in patients with major depression responding to a course of treatment with rTMS. Twelve subjects treated successfully with rTMS monotherapy underwent both RTD and sham depletion in a double-blind crossover design. Depressive symptoms were assessed using both a modified Hamilton Depression Rating Scale (HDRS) and Beck Depression Inventory (BDI). The differential change in depression scores across the procedures was compared. No significant difference in mood symptoms was noted between RTD and the sham-depletion procedure on either continuous measures of depression, or in the proportions of subjects that met predefined criteria for a significant degree of mood worsening. Responders to rTMS are resistant to the mood perturbing effects of RTD. This suggests that rTMS does not depend on the central availability of serotonin to exert antidepressant effects in major depression. Depression Anxiety 24:537,544, 2007. © 2006 Wiley-Liss, Inc. [source]

    Treatment of cutaneous T-cell lymphoma with retinoids

    Chunlei Zhang
    ABSTRACT:, Retinoids are biologic regulators of differentiation, proliferation, apoptosis, and immune response. Retinoids (all- trans retinoic acid, 13- cis -retinoic acid, and the synthetic analogs isotretinoin, etretinate, and acitretin) have been used for years as monotherapy and/or in combination for treatment of cutaneous T-cell lymphomas (CTCL). Orally administered bexarotene, the first synthetic highly selective retinoid X receptor retinoid to be approved by the Food and Drug Administration for CTCL, was shown to be active against the cutaneous manifestations of all stages of CTCL. The topical gel formulation was also effective for early cutaneous manifestations of CTCL or as an adjunct to systemic or phototherapy. Use of retinoids in future long-term clinical trials and their eventual application in CTCL regiments will require strategies to decrease the side effects of existing retinoids, identify novel receptor subtype-selective retinoids with better therapeutic index, and explore biologically based synergistic combination therapies with other active agents. [source]

    Therapy of circadian rhythm disorders in chronic fatigue syndrome: no symptomatic improvement with melatonin or phototherapy

    G. Williams
    Abstract Background Patients with chronic fatigue syndrome (CFS) show evidence of circadian rhythm disturbances. We aimed to determine whether CFS symptoms were alleviated by melatonin and bright-light phototherapy, which have been shown to improve circadian rhythm disorders and fatigue in jet-lag and shift workers. Design Thirty patients with unexplained fatigue for > 6 months were initially assessed using placebo and then received melatonin (5 mg in the evening) and phototherapy (2500 Lux for 1 h in the morning), each for 12 weeks in random order separated by a washout period. Principal symptoms of CFS were measured by visual analogue scales, the Shortform (SF-36) Health Survey, Mental Fatigue Inventory and Hospital Anxiety and Depression Scale. We also determined the circadian rhythm of body temperature, timing of the onset of melatonin secretion, and the relationship between these. Results Neither intervention showed any significant effect on any of the principal symptoms or on general measures of physical or mental health. Compared with placebo, neither body temperature rhythm nor onset of melatonin secretion was significantly altered by either treatment, except for a slight advance of temperature phase (0·8 h; P = 0·04) with phototherapy. Conclusion Melatonin and bright-light phototherapy appear ineffective in CFS. Both treatments are being prescribed for CFS sufferers by medical and alternative practitioners. Their unregulated use should be prohibited unless, or until, clear benefits are convincingly demonstrated. [source]

    The Synthesis of the Dimethyl Ester of Quino[4,4a,5,6- efg]-Annulated 7-Demethyl-8-deethylmesoporphyrin and Three of Its Isomers with Unprecedented peri -Condensed Quinoline Porphyrin Structures.

    Molecules with Outstanding Properties as Sensitizers for Photodynamic Therapy in the Far-Red Region of the Visible Spectrum
    Abstract The mesoporphyrin dimethyl ester nickel complex has been formylated via the Vilsmeier method. The four possible mono meso-formyl derivatives were isolated and characterized. Wadsworth,Emmons coupling with the anion of (diethylphosphono)acetonitrile converted these aldehydes into the four novel meso acrylonitriles. Brief treatment of these acrylonitrile systems in hot trichloroacetic acid resulted in the formation of four achiral porphyrin derivatives with unprecedented nickel complexes of quino-fused porphyrins. Subsequent removal of the nickel gave four quino-porphyrin free bases: quino[4,4a,5,6- efg]-annulated 7-demethyl-8-deethylmesoporphyrin dimethyl ester 6a, 2,-(methoxycarbonyl)quino[4,4a,5,6- jkl]-annulated 12-demethyl-13-de[2,-(methoxycarbonyl)ethyl]mesoporphyrin dimethyl ester 6b, 2,-(methoxycarbonyl)quino[4,4a,5,6- qrs]-annulated 18-demethyl-17-de(2,-methoxycarbonylethyl)mesoporphyrin dimethyl ester 6c and quino[4,5,6,7- abt]-annulated 2-demethyl-3-deethylmesoporphyrin dimethyl ester 6d. The structures of these systems were unambiguously determined via mass spectroscopy and a plethora of NMR techniques. In the same way, etioporphyrin and octaethylporphyrin were converted into the corresponding peri -condensed quinoporphyrins as products, which shows that the formation of novel pericondensed quino-porphyrins is a general reaction in the porphyrin series and will have a wide scope in this field. Also, a plausible reaction mechanism for the formation of the quinoporphyrin systems was derived. As a first test for the use of these systems as sensitizers in far-red phototherapy, the quantum yield of singlet oxygen generation by 6a in toluene was studied. This quantum yield is 0.77, which is even higher than the singlet oxygen generation by sensitized meso-tetraphenylporphyrin. Secondly, when Chinese Hamster ovary (CHO) cells were incubated in medium which contained up to 15 ,g/ml of 6a, the survival rate of the cells in the dark is complete within experimental error, showing that under these conditions, 6a is not toxic to CHO cells. When CHO cells incubated in medium containing 6a in concentrations of 1 ,g/ml and higher were treated with white light of intensity 30 mW/cm2 for 15 minutes, complete cell death was observed. Based on these facts, we expect that all four achiral systems will show very promising properties to form the basis of a photodynamic therapy in far-red light. The fact that these systems are achiral is an additional bonus for medical applications. (© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2004) [source]

    Influence of narrowband UVB phototherapy on vitamin D and folate status

    Emanuela Cicarma
    Please cite this paper as: Influence of narrowband UVB phototherapy on vitamin D and folate status. Experimental Dermatology 2010; 19: e67,e72. Abstract Background:, A variety of studies have shown beneficial effects of different types of phototherapy in skin disorders. Such therapy leads to enhanced cutaneous vitamin D synthesis, which may be one of the mechanisms of action. Furthermore, another nutrient, folate, can probably also be influenced by UV radiation. Objective:, The aim of our study was to investigate the influence of low-dose narrowband UVB (nUVB) phototherapy of patients with psoriasis, atopic eczema and other skin disorders on serum levels of 25(OH) vitamin D (the serum marker for vitamin D status) and on serum and erythrocyte-folate. Methods:, 25(OH) vitamin D (25(OH)D), serum and erythrocyte-folate levels were measured before and after low-dose nUVB (TL-01 tubes) phototherapy of these patients. The spectrum of the TL-01 tube was compared with the solar spectrum, and the efficiency spectra of vitamin D photosynthesis were calculated. Results:, For patients with a high initial 25(OH)D serum level (> 80 nmol/l), no significant (P = 0.36) increase in 25(OH)D levels was seen, in contrast to patients with a low initial level (< 80 nmol/l) where a significant increase (P < 0.001) was observed. The increase was 30,60%, depending on the UVB dose (2.35,13.4 J/cm2). No significant nUVB-effect was found on the erythrocyte and serum-folate level. Conclusion:, Low-dose nUVB treatment gives a significant increase (P < 0.001) of the vitamin D status in persons with low initial levels of 25(OH)D, but no effect on the folate level. [source]

    Fabrication of a Multilayered Low-Temperature Cofired Ceramic Micro-Plasma-Generating Device

    Amanda Baker
    Plasma technology is currently being used in innumerable industrial applications. Some of the common uses of this technology include surface cleaning and treatment, sputtering and etching of semiconductor devices, excitation source for chemical analyses, cutting, environmental cleanup, sterilization, and phototherapy. The harsh conditions that these devices must endure require robust refractory materials systems for their fabrication and reliability. Low-temperature cofired ceramic (LTCC) material systems provide a durable and cost-effective platform for the manufacture of such devices, and allow for possible integration into meso-scale microsystems. Our designs are based on RF microstriplines that capacitively couple and ionize small gas discharge sites over the top electrode. In this paper, we have built several iterations of this micro-plasma generating device using LTCC material systems. The impact of electrode ink selection and processing, lamination methods, dielectric layer thickness, and electrode design has been investigated. Several micro-plasma-generating devices were then evaluated for power requirements, output stability, and long-term reliability. [source]

    Vitiligo: the historical curse of depigmentation

    George W. M. Millington BSC
    Vitiligo has been mentioned in the tomes of every major religion, with its first description dating back more than 3000 years, to the earliest Vedic and Egyptian texts. Despite this ancient recognition, confusion with disorders such as leprosy has been a problem throughout the ages. This has lead to the stigmatization of vitiligo sufferers. This is a social problem that is still widespread in some, but not all, parts of the world. The ancients also practiced phototherapy for vitiligo. This practice only became common in the Western world with development of psoralen plus ultraviolet A and later ultraviolet B phototherapy in the latter half of the 20th century. In this article, the history of vitiligo up until the end of the 20th century is outlined, covering medical, scientific, and social aspects. [source]

    Two cases of generalized lichen nitidus treated successfully with narrow-band UV-B phototherapy

    You Chan Kim MD
    Background, Narrow-band ultraviolet (UV) phototherapy has not been used in the treatment of lichen nitidus. Aim, To report two cases of generalized lichen nitidus successfully treated with narrow-band UV-B phototherapy. Methods, A 7-year-old girl presented with a persisting, asymptomatic, papular eruption refractory to topical steroid for 3 months. Another 10-year-old boy presented with an asymptomatic papular eruption present for 6 months. The histopathologies of both lesions were consistent with lichen nitidus. The lesions were treated with narrow-band UV-B phototherapy. Results, The lesions of the patients were almost completely cleared after the 30th and the 17th irradiation, respectively. Conclusions, Narrow-band UV-B may be an effective alternative therapy for the treatment of generalized lichen nitidus unresponsive to common therapies. [source]

    UVB phototherapy and skin cancer risk: a review of the literature

    Ernest Lee MD
    Background, UVB phototherapy is a common treatment modality for psoriasis and other skin diseases. Although UVB has been in use for many decades, many clinicians are hesitant to use this type of phototherapy because of concern over increasing the skin cancer risk. Over the past 20 years, numerous studies have been published examining this issue, but a consensus or analysis of the skin cancer risk is required for the dermatologist to make an educated risk,benefit analysis. Objective, To assess the risk of skin cancer associated with UVB phototherapy. Methods, All prospective or retrospective studies were identified in MEDLINE from 1966 to June 2002. Bibliographies were searched to identify any additional studies examining this issue. All studies that attempted to quantify or qualify any additional skin cancer risk from UVB phototherapy were included. Study selection was performed by two independent reviewers. Results, Eleven studies (10 of which concerned psoriasis patients), involving approximately 3400 participants, were included. Of note, three of the studies involved the same cohort: members of the 16-center US Psoralen plus UVA (PUVA) Follow-up Study. Other than the most recent Finnish study, all studies eventually showed no increased skin cancer risk with UVB phototherapy. One of the PUVA cohort studies examined genital skin cancers, and found an increased rate of genital tumors associated with UVB phototherapy, although this study has not been duplicated. Conclusion, The evidence suggests that UVB phototherapy remains a very safe treatment modality. [source]

    Willan's itch and other causes of pruritus in the elderly

    Jon R. Ward MD
    Itch in the elderly presents a diagnostic and therapeutic challenge. A thorough history, review of systems, and physical examination are critical to determining its cause. Examination of the skin may be misleading. There are frequently only secondary lesions, eczematous changes, lichenification, and excoriation, which may be misdiagnosed as a primary dermatitis. Xerosis may be the cause, but it is sometimes merely coincidental. If primary lesions are present, a skin biopsy can enable a diagnosis to be made. Systemic causes of itch, such as cholestasis, uremia, hyperthyroidism, medications, or lymphoma, must be considered. If the cause remains elusive, idiopathic itching of the elderly or so-called "senile pruritus" may be considered. However, we propose to discard the term "senile pruritus", which can be offensive and frightening. We propose to replace it with "Willan's itch". Robert Willan (1757,1812) is honored as one of the founders of modern dermatology thanks to his book, On Cutaneous Diseases, and its morphological approach to skin disease. He was probably the first to give a good clinical description of itching in the elderly. The diagnosis of Willan's itch should be reserved for generalized pruritus in the absence of xerosis or other recognizable cause. The pathophysiology of this form of pruritus is poorly understood, but it is likely that age-related changes of the skin, cutaneous nerves, and other parts of the nervous system play a role. Anecdotal and limited data suggest that gabapentin, cutaneous field stimulation, serotonin antagonists, and ultraviolet B phototherapy may attenuate itch in some of these patients. [source]

    Diagnosis and Therapy of Localized Scleroderma

    Alexander Kreuter
    Abstract Localized scleroderma is a rare autoimmune disease with primary affection of the skin, and occasional involvement of the fat tissue, muscle, fascia, and bone. Depending on the clinical subtype, the spectrum of skin lesions ranges from singular plaque lesions to severe generalized or linear subtypes which may lead to movement restrictions and permanent disability. This German S1-guideline proposes a classification of localized scleroderma that, considering the extent and depth of fibrosis, distinguishes limited, generalized, linear, and deep forms of localized scleroderma, together with its associated subtypes. The guideline includes a description of the pathogenesis, of differential diagnoses, and particular aspects of juvenile localized scleroderma, as well as recommendations for histopathologic, serologic, and biometric diagnostic procedures. Based on studies of topical and systemic treatments as well as phototherapy for localized scleroderma published in international literature, a treatment algorithm was developed which takes account of the different subtypes and the extent of disease. [source]

    Examples for the importance of radiophysical measurements in clinical phototherapy

    Lars Alexander Schneider
    Summary Background: Optimal UV therapy requires regular surveillance of the variables that influence therapeutic success. In daily practice, phototherapy equipment is often operated with an attitude of "autocontrol." This implies that thorough control measurements of the emission spectra and calibration of UV fluences are not routinely performed. For both quality control and patient safety, it is essential to regularly check whether a UV source is providing the right target spectrum with the correct dose to the skin. Methods: We have exemplarily taken three UV sources currently used in clinical practice and performed radiophysical measurements, i. e. determined emission spectra, radiation output and correctness of dose calculation. Results: All three sources revealed either a largely inhomogeneous distribution pattern of radiation intensity, variation of radiation intensity over time or insufficient filtering of the UV lamp emission spectrum. Furthermore the dose calculation procedures had to be revised because of significant differences between the estimated and the administered UV doses. Conclusions: Radiophysical measurement of all UV-equipment in clinical use is a simple and effective way to improve the safety and reliability of phototherapy. Such measurements help to uncover technical flaws in radiation sources and prevent unnecessary side effects and UV exposure risks for the patient. [source]

    Attenuation of TCDD-induced oxidative stress by 670 nm photobiomodulation in developmental chicken kidney

    Jinhwan Lim
    2,3,7,8-Tetrachlorodibenzo- p -dioxin (TCDD), a potent developmental teratogen inducing oxidative stress and sublethal changes in multiple organs, provokes developmental renal injuries. In this study, we investigated TCDD-induced biochemical changes and the therapeutic efficacy of photobiomodulation (670 nm; 4 J/cm2) on oxidative stress in chicken kidneys during development. Eggs were injected once prior to incubation with TCDD (2 pg/g or 200 pg/g) or sunflower oil vehicle control. Half of the eggs in each dose group were then treated with red light once per day through embryonic day 20 (E20). Upon hatching at E21, the kidneys were collected and assayed for glutathione peroxidase, glutathione reductase, catalase, superoxide dimutase, and glutathione- S -transferase activities, as well as reduced glutathione and ATP levels, and lipid peroxidation. TCDD exposure alone suppressed the activity of the antioxidant enzymes, increased lipid peroxidation, and depleted available ATP. The biochemical indicators of oxidative and energy stress in the kidney were reversed by daily phototherapy, restoring ATP and glutathione contents and increasing antioxidant enzyme activities to control levels. Photobiomodulation also normalized the level of lipid peroxidation increased by TCDD exposure. The results of this study suggest that 670 nm photobiomodulation may be useful as a noninvasive treatment for renal injury resulting from chemically induced cellular oxidative and energy stress. © 2008 Wiley Periodicals, Inc. J Biochem Mol Toxicol 22:230,239, 2008; Published online in Wiley InterScience ( DOI 10.1002/jbt.20233 [source]