Medium-dose is more effective than low-dose ultraviolet A1 phototherapy for localized scleroderma as shown by 20-MHz ultrasound assessment.

Abstract

BACKGROUND:

Recent studies suggest that ultraviolet (UV) A1 phototherapy is an effective treatment for localized scleroderma (LS); however, the optimum UVA1 dose remains to be determined.

OBJECTIVE:

We sought to compare the immediate and long-term efficacy of low- versus medium-dose UVA1 phototherapy for plaque-type LS.

METHODS:

Three comparable plaques in 16 patients were treated with 20 J/cm2 UVA1, 70 J/cm2 UVA1, or no irradiation. In total, 30 treatments were given. Skin thickness was determined by high-frequency ultrasound examination and clinical scoring. Assessments were done at baseline, immediately after treatment, and 3, 6, and 12 months thereafter.

RESULTS:

Ultrasound measurement showed a significantly greater reduction of skin thickness with 70 J/cm2 than with 20 J/cm2 at all time points of the study except immediately after UVA1 treatment. The clinical score of the irradiated plaques also decreased substantially but failed to detect a significant difference between the two dose regimens.

LIMITATIONS:

Our results only pertain to plaque-type LS and are limited by a small sample size.

CONCLUSION:

Medium-dose provides for better long-term results than low-dose UVA1 in LS as shown by ultrasound assessment. With clinical scoring, no significant difference between the two UVA1 dose regimens was detected, indicating that ultrasound measurement is a more sensitive method for quantifying treatment-induced skin changes in patients with LS.

• Authors: Paul-Gunther Sator, Sonja Radakovic, Karl Schulmeister, Herbert Hönigsmann, Adrian Tanew
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 60 Issue 5 Pg. 786-91 (May 2009) ISSN: 1097-6787 [Electronic] United States
• PMID: 19211170 (Publication Type: Comparative Study, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Radiotherapy Dosage
• Scleroderma, Localized (radiotherapy)
• Skin (diagnostic imaging, radiation effects)
• Treatment Outcome
• Ultrasonography
• Ultraviolet Therapy (instrumentation, methods)