Annelies Avermaete

Combined Treatment with Calcipotriol Ointment and Low-Dose Ultraviolet A1 Phototherapy in Childhood Morphea

Abstract: Various therapies for morphea have been used with limited success, including ones with potentially hazardous side effects. When morphea occurs in childhood it may lead to progressive and long‐lasting induration of the skin and subcutaneous tissue, growth retardation, and muscle atrophy. We report an open prospective study in which the efficacy of a combined treatment with calcipotriol ointment and low‐dose ultraviolet A1 (UVA1) phototherapy in childhood morphea was investigated. Nineteen children (mean age 8.5 years, range 3–13 years) with morphea were exposed to UVA1 (340–400 nm) phototherapy at a dose of 20 J/cm2 four times a week for 10 weeks. Forty phototherapy sessions resulted in a cumulative dose of 800 J/cm2 UVA1. In addition, calcipotriol ointment (0.005%) was applied twice a day. After 10 weeks, palpation and inspection showed a remarkable softening and repigmentation of formerly affected skin resulting in a highly significant (p < 0.001) decrease of the mean clinical score from 7.3 ± 0.9 at the beginning to 2.4 ± 0.9 (relative reduction 67.1%) at the end of combined therapy. Our results indicate that a combined therapy with calcipotriol ointment and low‐dose UVA1 phototherapy is highly effective in childhood morphea. Further controlled studies are necessary to investigate whether this combined therapy is superior to UVA1 phototherapy alone.

Influence of wetness on the ultraviolet protection factor (UPF) of textiles: in vitro and in vivo measurements

Background/Purpose: Clothing is an important product for sunburn protection and skin cancer prevention. The moisture content of a fabric, which can increase during its wearing, may decrease the fabrics capability of protecting the skin from solar UV radiation, that is, lower its UPF (ultraviolet protection factor). Due to limited data about the effect of fabric wetness on UPF, this study was undertaken to investigate the following: (a) the effect of saturating a variety of fabrics with tap water and with salt water on fabric UPF and (b) whether wetted‐fabric UPF values reflect only the fact that the fabric is wet during testing or the fact that the skin is hydrated and the fabric is wet.

Ultraviolet protection by summer textiles. Ultraviolet transmission measurements verified by determination of the minimal erythema dose with solar-simulated radiation

Background  Apart from sunscreen lotions, clothing provides protection from acute and chronic sun damage. Therefore, it is very important to know the ultraviolet (UV) protection factor (UPF) of textiles, in particular of lightweight summer clothing. Usually, the UPF of a textile is determined by spectrophotometric assessment of the UV transmission (in vitro method).

Plasma levels of opioid peptides after sunbed exposures

Summary Background  Previous studies have indicated that solar and artificial ultraviolet (UV) radiation have a positive influence on psychological variables such as mood and emotional state. Circulating opioid peptides have been suggested as being important in this effect.

Differences in the Two-Dimensionally Measured Laser Doppler Flow at Different Skin Localisations

The cutaneous microcirculation shows a significant heterogeneity. With high-resolution two-dimensional laser Doppler perfusion imaging (LDPI), spatial and temporal reproducible perfusion measurements can be reached. The objective of this study was the quantification of skin perfusion in 20 defined skin areas with LDPI, in 60 healthy young and old volunteers. The perfusion of the face was significantly higher than that of the trunk and extremities. The highest perfusion values were seen at the lips, 1.47 arbitrary units (AU), followed by the chin (0.99 AU), the nose (0.95 AU), the forehead (0.73 AU) and the cheek (0.72 AU). Mean perfusion, between 0.40 and 0.49 AU, was seen at the extremities and at the trunk. The lowest perfusion was found at the bottom (0.37 AU), on the back of the foot (0.36 AU) and on the soles (0.31 AU). There was a tendency to show higher perfusion values in men than in women (0.60 ± 0.31 vs. 0.53 ± 0.26 AU). Age-related differences in perfusion could not be demonstrated. In the evaluation of the perfusion of pathological skin, regional perfusion differences must be considered, whereas moderate age or gender differences between different investigation groups can be tolerated.

Mechanisms of apoptosis: UVA1‐induced immediate and UVB‐induced delayed apoptosis in human T cells in vitro†

Objective The decreased number of lymphocytes combined with the induction of apoptosis and necrosis seems to be the key mechanism of many phototherapeutic agents. The purpose of our study was to determine the regulating pathway, time course and dose dependence of UVA1‐ vs. UVB‐induced cell death in human T lymphocytes.

Efficacy of ultraviolet A1 phototherapy on the expression of bcl-2 in atopic dermatitis and cutaneous T-cell lymphoma in vivo: a comparison study

Background/Purpose: Atopic dermatitis (AD) is characterized immunohistochemically by a high number of skin infiltrating T‐helper cells (CD4 + ). In most cases cutaneous T‐cell lymphoma (CTCL) is characterized by a malignant proliferation of CD4 +  T‐helper lymphocytes. The purpose of our study was to evaluate the extent of anti‐apoptotic effects in patients suffering from AD or CTCL, respectively, which may contribute to the prolonged inflammation. Furthermore, we investigated whether medium‐dose ultraviolet A1 (UVA1) phototherapy is able to modulate the expression of bcl‐2 within the dermal inflammatory infiltrate.

Ultraviolet protection factor of fabrics: comparison of laboratory and field-based measurements.

Background/purpose: Spectrophotometry has become an accepted laboratory‐based method for the determination of the ultraviolet protection factor (UPF) of fabrics. However, the validity of the UPF determined in the laboratory has been a controversial issue with regard to its significance in the field. To compare UPF values obtained by spectrophotometry, determination of the minimal erythema dose (MED), and biological dosimetry, we conducted laboratory and field‐based measurements on various fabric materials.

Repeatability of in vitro measurements of the ultraviolet protection factor (UPF) by spectrophotometry with automatic sampling.

Background/aims: Spectrophotometric assessment (in vitro) is the most established method for determining the ultraviolet protection factor (UPF) of textiles. Apart from stringent requirements for measurement precision, practical methods are required for the routine determination of the UPF. We report here spectrophotometric measurements of textiles using a newly developed autosampler. Measurement precision was evaluated under repeatable conditions.

Modulation of cathepsin G expression in severe atopic dermatitis following medium-dose UVA1 phototherapy.

BackgroundDuring the last decade, medium-dose UVA1 phototherapy (50 J/cm2) has achieved great value within the treatment of severe atopic dermatitis (AD). The purpose of our study was to investigate to what extent UVA1 irradiation is able to modulate the status of protease activity by the use of a monoclonal antibody labeling cathepsin G.MethodsIn order to further elucidate the mechanisms by which medium-dose UVA1 irradiation leads to an improvement of skin status in patients with AD, biopsy specimens from 15 patients before and after treatment were analyzed immunohistochemically for proteolytic activation.ResultsCompared to lesional skin of patients with AD before UVA1 irradiation, the number of cells positive for cathepsin G within the dermal infiltrate decreased significantly after treatment. The decrease of cathepsin G+ cells was closely linked to a substantial clinical improvement in skin condition.ConclusionsIn summary, our findings demonstrated that medium-dose UVA1 irradiation leads to a modulation of the expression of cathepsin G in the dermal inflammatory infiltrate in patients with severe AD. Cathepsin G may attack laminin, proteoglycans, collagen I and insoluble fibronectin, to provoke proinflammatory events, to degrade the basement membrane, to destroy the tissue inhibitor of metalloproteinases and to increase the endothelial permeability. Therefore, its down-regulation by UVA1 phototherapy may induce the reduction of skin inflammation as well as improvement of the skin condition.