Clinical manifestations of the skin photodamage as a result of a multi-course phototherapy of psoriasis patients

Cover Page


Cite item

Full Text

Abstract

Goal. To study clinical manifestations and frequency of skin photodamage symptoms in psoriasis patients receiving a longterm multi-course phototherapy. Materials and methods. The study involved 106 patients suffering from psoriasis vulgaris and receiving a multi-course treatment by methods of the PUVA therapy, broadband medium-wave UV therapy and narrowband phototherapy with the wavelength of 311 nm. The average number of courses was 7 while the average number of treatment sessions was 141. Depending on the number of treatment sessions, the patients were divided into three groups: Group 1 (n = 33) - patients that received 50-100 phototherapy sessions, Group 2 (n = 58) - patients that received 101-200 treatment sessions, and Group 3 (n = 15) - patients that received over 200 treatment sessions. The control group comprised 20 psoriasis patients that did not receive any phototherapy before. Major results. The comparative analysis of the entire group of patients receiving a phototherapy revealed a statistically significant incidence of lentigo/sunspots, diffuse skin hyperpigmentation and actinic elastosis vs. the control group. The frequency of clinical manifestations characteristic of the skin photodamage grew as the number of treatment sessions increased. All of the symptoms except for guttate hypomelanosis and venous lakes demonstrated statistically significant dynamics. Conclusion. There is a dose-dependant increase in the frequency of skin photodamage symptoms in patients suffering from psoriasis vulgaris and receiving a long-term multi-course phototherapy.

About the authors

M. B. Zhilova

State Research Center of Dermatovenereology and Cosmetology, Ministry of Healthcare of the Russian Federation

Author for correspondence.
Email: zhilova@cnikvi.ru
Russian Federation

V. A. Volnukhin

State Research Center of Dermatovenereology and Cosmetology, Ministry of Healthcare of the Russian Federation

Email: noemail@neicon.ru
Russian Federation

A. S. Dvornikov

The Russian National Research Medical University named after N.I. Pirogov (RNRMU)

Email: noemail@neicon.ru
Russian Federation

References

  1. Дерматология Фицпатрика в клинической практике: в 3 т. Клаус Вольф, Лоуэлл А. Голдсмит, Стивен И. Кац, Барбара А. Джилкрест, Эми С. Паллер, Дэвид Дж. Леффель // Под ред. акад. А.А. Кубановой. М.: Издательство Панфилова; БИНОМ. Лаборатория знаний 2012; 1: 180-207
  2. Wolff K. Side-effects of psoralen photochemotherapy (PUVA). Br J Dermatol 1990; 122: 117-125.
  3. Stern R.S., Nichols K.T., Vakeva L.H. Malignant melanoma in patients treated for psoriasis with methoxsalen (psoralen) and ultraviolet A radiation (PUVA). N Engl J Med 1997; 336: 1041-1045.
  4. Lindelöf B., Sigurgeirsson B., Tegner E. et al. PUVA and cancer risk: the Swedish follow-up study. Br J Dermatol 1999; 141: 108-112.
  5. Stern R.S.; PUVA Follow-Up Study. The risk of squamous cell and basal cell cancer associated with psoralen and ultraviolet A therapy: a 30-year prospective study. J Am Acad Dermatol 2012; 66 (4): 553-562.
  6. Archier E., Devaux S., Castela E. et al. Carcinogenic risks of psoralen UV-A therapy and narrowband UV-B therapy in chronic plaque psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol 2012; 26 Suppl 3: 22-31.
  7. Смирнова И.О. Функциональная морфология старения кожи. Успехи геронтологии 2004; 13: 44-51
  8. Matsumura Y., Ananthaswamy H.N. Toxic effects of ultraviolet radiation on the skin. Toxicol Appl Pharmacol 2004; 195 (3): 298-308.
  9. Rhodes A.R., Stern R.S., Melski J.W. The PUVA lentigo: an analysis of predisposing factors. J Invest Dermatol 1983; 81: 459-463.
  10. Ros A.M., Wennersten G., Lagerholm B. Long-term photochemotherapy for psoriasis: a histopathological and clinical follow-up study with special emphasis on tumour incidence and behavior of pigmented lesions. Acta Derm Venereol 1983; 63 (3): 215-221.
  11. Cox N.H., Jones S.K., Downey D.J. et al. Cutaneous and ocular side-effects of oral photochemotherapy: results of an 8-year follow-up study. Br J Dermatol 1987; 116 (2): 145-152.
  12. Abdullah A.N., Keczkes K. Cutaneous and ocular side-effects of PUVA photochemotherapy-a 10-year follow-up study. Clin Exp Dermatol. 1989; 14 (6): 421-424.
  13. Stern R.S. Actinic degeneration and pigmentary change in association with psoralen and UVA treatment: a 20-year prospective study. J Am Acad Dermatol 2003; 48: 61-67.
  14. Nakagawa H., Rhodes A.R., Momtaz T.K. et al. Melanosomal alterations in PUVA lentigines (Abstr). J Invest Dermatol 1983; 80: 378.
  15. Gschnait F., Wolff K., Hönigsmann H. et al. Long-term photochemotherapy: histopathological and immunofluorescence observations in 243 patients. Br J Dermatol 1980; 103 (1): 11-22.
  16. Hönigsmann H., Wolff K., Gschnait F., Brenner W., Jaschke E. Keratoses and nonmelanoma skin tumors in long-term photochemotherapy (PUVA). J Am Acad Dermatol 1980; 3 (4): 406-414.
  17. Abel E.A., Cox A.J., Farber E.M. Epidermal dystrophy and actinic keratoses in psoriasis patients following oral psoralen photochemotherapy (PUVA). Follow-up study. J Am Acad Dermatol. 1982; 7 (3): 333-340.
  18. van Praag M.C., Bavinck J.N., Bergman W. et al. PUVA keratosis. A clinical and histopathologic entity associated with an increased risk of nonmelanoma skin cancer. J Am Acad Dermatol 1993; 28 (3): 412-417.
  19. Lever L.R., Farr P.M. Skin cancers or premalignant lesions occur in half of high-dose PUVA patients. Br J Dermatol 1994; 131 (2): 215-219.
  20. Олисова О.Ю., Владимиров В.В., Лукашева Н.Н., Пушкина М.Ю., Смирнов К.В. Отдаленные результаты ПУВА-терапии дерматозов (обзор литературы). Росс журн кожн вен бол 2005; 1: 30-33

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2014 Zhilova M.B., Volnukhin V.A., Dvornikov A.S.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 60448 от 30.12.2014.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies