Anne-Marie Ros

Photodynamic therapy with topical 5-aminolevulinic acid for mycosis fungoides : Clinical and histological response

There is no curative treatment for mycosis fungoides (MF), the most common primary cutaneous T-cell lymphoma. The aim of this study was to investigate the response of single lesions to photodynamic therapy (PDT). The study included 10 plaque MF lesions and 2 tumour MF lesions from 10 patients. First, 20% 5-aminolevulinic acid was applied topically to the lesion and adjacent skin for 5-6 h. The lesion was then exposed to red light at around 630nm. Skin biopsies were taken before treatment, after clinical improvement and after clinical remission. The expression of CD3, CD4, CD7, CD8, CD1a, CD34, CD68, CD71, Ki-67, bcl-2 and p53 was studied immunohistochemically. There was complete clinical clearance in seven of nine plaque lesions. Neither tumour lesion responded to PDT. The biopsies confirmed a regression of the infiltrate after treatment. In the sparse remaining infiltrate a few CD4+ and CD8+ cells were found, most of which showed normal bcl-2. There were also fewer proliferating cells, illustrated by a decrease in Ki-67 and CD71. In conclusion, PDT has good clinical and histological effects in treating local plaque MF lesions.

The treatment of port-wine stains with the pulsed dye laser at 600 nm

The standard wavelength in the treatment of port‐wine stains (PWS) with the pulsed dye laser is 585 nm. In many cases, the response to therapy is not adequate despite many treatments, depending partly on vessels out of reach of the laser. Longer wavelengths penetrate deeper into the dermis, but are absorbed less by oxyhaemoglobin, and require higher fluences. In this study, 22 patients with PWS were treated with the flashlamp‐pumped pulsed dye laser using two different wavelengths, 585 and 600 nm. Four adjacent sites with PWS were treated on one occasion with 585 nm, 600 nm and equal fluence, and with 1.5 and 2 times the 585 nm fluence. The test areas were examined blindly, by four evaluators, an average of 12.5 weeks later. There was significantly less lightening with 600 nm than with 585 nm (P0.001) when equal fluences were used. When 1.5 and 2 times the 585 nm fluence were applied, with 600nm the lightening was equal to that after 585 nm. However, in individual cases (11 of 22) 600 nm showed a superior lightening of at least 20% compared to 585 nm. There was slight hyperpigmentation and hypopigmentation, but no atrophy or scarring. In conclusion, 585 nm remains the wavelength of choice in treatment of PWS with the pulsed dye laser. However, in cases that do not respond satisfactorily with 585 nm, it may be worth trying 600 nm with a fluence that is at least 1.5–2 times the 585 nm fluence.

The mutagenic effect of ultraviolet‐A1 on human skin demonstrated by sequencing the p53 gene in single keratinocytes

Background:  Sun exposure is accepted as the major risk factor for developing skin cancer, the most common cancer in the western world. Ultraviolet‐B (UV‐B) radiation is considered the causative agent, but recently several findings suggest a role also for ultraviolet‐A (UV‐A) radiation. Repeated suberythemal doses of ultraviolet‐A1 (UV‐A1) on healthy human skin induce an increase of p53 immunoreactive cells in epidermis, which may indicate cell cycle arrest and/or occurrence of p53 mutations.

Clinical and immunohistochemical evaluation of psoriatic plaques treated with topical 5‐aminolaevulinic acid photodynamic therapy

Background/purpose: The aims of this study were to investigate the clinical and immunohistochemical events of psoriatic plaques during photodynamic therapy (PDT) using topical application of 5‐aminolaevulinic acid (ALA).

Effects on human skin of repetitive ultraviolet-A1 (UVA1) irradiation and visible light.

Background: Ultraviolet radiation (UVR) has a variety of effects on human skin. Best known are the effects of UVB (290–320 nm) and UVA2 (320–340 nm), which cause DNA damage and increased risk of cancer. However, the effects of UVA1 (340–400 nm) have been not completely investigated.

The Prevalence of Hepatitis C in Patients with Porphyria Cutanea Tarda in Stockholm, Sweden

In many countries hepatitis C virus infection has been considered a major factor triggering overt porphyria cutanea tarda. The prevalence of hepatitis C virus infection was retrospectively studied in 87 patients who during a period of 11 years were diagnosed with porphyria cutanea tarda in Stockholm. Among patients with the sporadic form of porphyria cutanea tarda, the prevalence of hepatitis C virus infection was 36.4%. As hepatitis C virus infection may today be successfully treated and as the infection may be clinically silent and thus unknown to the patient, it is important to screen all patients with porphyria cutanea tarda for hepatitis C virus infection.

T Cell Subpopulations and Their Functions in vitro

T lymphocyte subpopulations and their in vitro activities were determined in patients with alopecia areata (AA) and alopecia universalis (AU). The frequencies of T cells with receptors for IgG and T cells with receptors for IgM were determined in 16 cases. The IgG and IgM production of B lymphocytes cocultured with autologous and allogeneic T lymphocytes in the presence of PWM was determined in 12 and 9 cases, respectively, and the antibody-dependent cell-mediated cytotoxicity (ADCC) of unfractionated lymphocytes was examined in 6 cases. Patients with AA and AU had a higher proportion of Tg cells and more pronounced ADCC of unfractionated peripheral lymphocytes than normal persons. Furthermore, PWM-induced Ig production of B lymphocytes in the presence of autologous T lymphocytes seemed to be lower than that of controls.

T Lymphocyte Subpopulations and Pokeweed Mitogen-Induced Immunoglobulin Synthesis in vitro by Mononuclear Cells from Psoriasis Patients

T-lymphocyte subpopulations and pokeweed mitogen(PWM)-induced immunoglobulin (Ig) synthesis of mononuclear cells in vitro were studied in patients with psoriasis as well as in age- and sex-matched normal blood donors. The frequences of T cells with receptors for IgG (Tg) and T cells with receptors for IgM (Tm) were examined. The IgG and IgM synthesis in mononuclear cell suspensions in the presence of different amounts of PWM was determined. The percentage of total T cells (rosetting with neuroaminidase-treated sheep red blood cells), including high and low affinity T lymphocytes showed no difference between the patient group and controls. The patients with psoriasis had a significantly higher mean proportion of Tg cells than the normal donors whereas there was no significant difference in the proportions of Tm cells between these two groups. The PWM-induced Ig synthesis in the mononuclear cell suspension seemed lower in patients with psoriasis than in controls, the difference being statistically significant when the results were expressed as ratios of Ig amounts present in the supernatants of PWM-stimulated and non-stimulated cultures (index of stimulation).