- Email: [email protected]
308 nm Excimer laser for psoriasis
ESDR 1 JSID I SID Abstracts
S231
1384 FROM UVB ERYTHEMA BY SYSTEMIC ANTIOXIDANTS JiirgenFuchs.Oepartment of Dermatology, J.W.Goethe University. Frankfurt. Germany. There is cumulative evidence that reactive oxidants are involved in the pathogenesis of UVB erythema. Conslderinq the well known antioxidant properties of D-alpha-tocopherol (TOC) and L-ascorbic acid (ASC). we investigated whether oral supplementation with these vitamins inEluenced the UVB erythema.Healthy volunteers were studied in a prospective and randomized trial. Group 1 receiving orally TOC Zg/day, group 2 taking ASC 3q/day, group 3 taking TOC Zg/day plus Ax %/day and orouo 4 takinu no suoolements. Before and after-50 bays oi daily auppl;mentatibn we analyzed Tot and ASC levels in buccal mucosal keratinocytes. which are a good indicator of skin mxcronutrients, and determined the PROTECTION
dose
resoonse cur"e of ““B ervthema. In all three suooleTOC and ASC levels were increased, and'ihe dose response curve showed a flattenlog at hiqher UVB doses, which-was most evident in the arouo receivins TOC plus ASC. However, all differences dib noi reach statistical significance due to large interindividual variability. The data implicate that megadose antioxidant supplementation 1s presumably not a feasible approach for achievement of acute UVB photoprotection. The topical use of natural antloxidants seems nevertheless to be a promising intervention strategy in photoprotection.
mented g;oups UVB
1382 308 nm EXCIMER LASER FOR PSORIASIS B. m ‘Dept. of Dennatol , A Scent-Gyiirgyi Medical Umv , *Dept of Optics and Quantum Electronics, A. J6rsef Univ. Szeged, Hungmy 311 nm UVB phototherapy is a widely-used treatment for psoriasis. Since the biological effects of laser light differ those of mcoherent light with the same wavelength, and the wavelength ofthe 308 nm xenon chloride (X&l) excimer laser is wthm the action spectrum for the phokotherapy of psoriasa, we have mvestigafed the theraoeunc effect of XeCl laser hekt for osorxir~ Ten Caucasianoatients Pntk chronic pl$e type psoriasis, within the age mnie 24-73 (mean 48 2) ye&s were studied One (2-3 cm diameter) of tkex plaques was treated with the 308 nm X&l exclmer laser The energy of each hght Impulse was 5.5 mJ/cm’, while the duration was 15 ns. Irradmnon was started at 20-98 impulses (mean 54 6) dependmg on skin type, wth an I l-impulse increase in dose each time, with 20 impulse/second rate Treatments were repeated three times weekly. In case of 6 paoents we compared the &icacy of 3 1I nm narrow band IJVB hght with the 308 nm IJVR laser. The number of treatmenti up to complete clearance with the 3 11 nm narrow band UVB light was 29-33 (mean 30 I), while that wth the 308 nm XeCl laser was S-10 (mean 8 33) The cumulatwe doses were 26 3 l-32 15 J/cm* (mean 31 1) and 2.57-8 I I J/cm’ (mean 4 81) for the 311 nm narrow band light and the 308 nm laser, respect&y Mdd and transient hypeqgmentation was observed but no orher side-effects These results suggest that treatment with thlslaser llghtismoreeffectlvethan 311nm UVB treatment andISwell worthy ofconsideration forfuturetreatment
1383 EXTRACORPOREAL ICTCLI. B
UV-A IRRADJATION WITH CARBOXYMETHYLATED GLUCAN FROM BAKER’S YEAST. Fred Ziilli and Franz Suter. Biochemisby Department, Mibelle AG Cosmetics, Buchs, Switzerland. Glucan is a poly !3-(1,3)-linked glucopyranose of high molecular weight from the cell wall of baker’s yeast and belongs to the class of compounds known as biological response modifiers. Studies have shown that these g&an preparations activate the body’s natural defense mechanisms. We have developed a process to modify the insoluble glucan polysacchtide to carboxymethyl glucan, a water-soluble product suitable for topical applications. Our cell culture experiments showed that carboxymethylated glucau protects skin cells against the depletion of antioxidant molecules upon UV-A irradiation. In placebo controlled studies, carboxymethylated glucan at a very low concentration (0.04%) was able to protect the skin against squalene peroxidation induced by W-A irradiation. We speculate that these effects regarding UV-A protection are based on an unspecific stimulation of skin cells by carboxymethylated glucan because in vitro lipid peroxidation experiments did not reveal protecting effects of the polysaccharide.
1386 PHOTOPHERESIS
FOR CUTANEOUS T-CELL LYMPHOMA t%re,men W. Lim f. Ronaldo.
DeptofDwmatolo~y. New YorkUniversity SchofMedicine. New York. NY. USA;*Dept ofDermatology, Henry Ford Hospital. Detro,t, Ml, USA. This study rewews the experience of treatment of patients with srvthradermlc CTCL with ~~tracorooreal ohotooheresis fECPl at the New York &ran Affairs Medal Cente,/NI;U Medical Center between 9/87 and 4197. FOR” one patients received photopheresis; 25 of them fulfilled the inclusion cnterion,v3., the compledon of 2 6 cydes of phctopheresis. Skinscorewas defined as a product of s~?,,,Y and percentage of involved surface 8,ea. Complete cli”,cal ,espo”se was defined 8s disappearance of measurable disease for at least one month. and partial response was defined as 2 So% clearance of measurable d,se.se ‘0, at least one month. The oroflle Of the “adents was: 20 men. 5 women: averaae aoe: 64.2 wars: 17 p&“ts had s&e 111d,seaSe, and 8 had srage I\ldise.&. Fyvveof the’25 patients ,20%, achieved camplete clinical response. another 15 160%) had oartial ,esoo”se, and 5 120961 had no ,esoo”se. The ave,a”e tmw to achieve clinical c,ea,ance WBS 12.6 ,rangs:4-30 an* the .we,a9e time to obtain pwtml clinical response was 9.6 months lrswe: 4-17 months). Remission duration ranged from 9 to 67 mo. The average CD4lCDS ratlo in the responders was 6.5 Irange: 1.7 to 201 while in the non-responders was 11 .O (range: 1 .S to 271. At the time of maximal clina response, the ratio in the responders was 1.4 l‘a”9e 1 .O to 2.1, Side effects were minimal. Therefore, ECP IS a” sffecti”e and safe tr~afment for eryfhrodermlc CTCL. In B minorny of these patients, lt ~a” lnducs B ion9 term and complete ~llnical
&mlplete
22irange 2.510451.
,e,,l,*Sl0”.
1385 SKINPROTECIION AGAINST OXIDATIVE STRESS INDUCED BY
monrhs
months1
while inthe“an-re~,,a”derr if was
A NEW USE FOR THE ULTRVIOLET-A IRRADIATED H.~~LESS MOUSE ASSAY OF ANTI-LNFLAh&fATORY TOPJCALS. L.H. Department of Dermatology, University of Pennsylvania, Philadelphia, PA. High dose WA exposure of hairless mice provokes a ~evefe neutrophilic infiltrate in the lower dermis. Topical corticosteriods have been shown to inhibit the infiltrate in a potency r&wed manner. In this study we examined diverse topic& some of which, such as retinoids, have been claimed to have anti-inflammatory properties. Hairless mice(4igroup) weretreated topically for7 dayswiththefollowing: (tretinoin (.Ol, .02.5, .OS%), its vehicle, salicytic acid (2,and 5%) glycolic acid (Ssb), Aknemycin, Napmxen, Thiabendazole, Metrogel, Euceti and petrolatom. Isopmpyl myristate served as a non-specific hyperplasiogenic control. On the 8th day, mice were anesthetized and exposed to WA (195 J/cm’ = 3 MED) from a WASUN 3OOOlamp (340-4oOnm) on a 2 co? area of dorsal tnmk skin. The remainder of the dorsum was treated with a sunscrew. Exposed skin wan excised 24 hr post-UV, fixed for light microscopy and stained with hematoxylin and eosin. Neuwophils in the lower de& were counted in IO fields/specimen under oil immersion. UVA controls hadanaverse of 70 neutrophiWfield. Tretinoin showed a dose dependent inhibition of the infiltrate from 48 fo 82%. Inhibition by the vehicle was 10% as was fhaf by isopropyl myristate which thickened the epidermis to a similar degree as uetinom. Significant inhibition was also seen with salicyhc acid (40 and 59%), glycolic acid (@i%),Thiabcndazole (44%) Aknemycin and pevolatum (20%). Metroeel. Eucerin and Naoroxen wee ineffectne.
S231
1384 FROM UVB ERYTHEMA BY SYSTEMIC ANTIOXIDANTS JiirgenFuchs.Oepartment of Dermatology, J.W.Goethe University. Frankfurt. Germany. There is cumulative evidence that reactive oxidants are involved in the pathogenesis of UVB erythema. Conslderinq the well known antioxidant properties of D-alpha-tocopherol (TOC) and L-ascorbic acid (ASC). we investigated whether oral supplementation with these vitamins inEluenced the UVB erythema.Healthy volunteers were studied in a prospective and randomized trial. Group 1 receiving orally TOC Zg/day, group 2 taking ASC 3q/day, group 3 taking TOC Zg/day plus Ax %/day and orouo 4 takinu no suoolements. Before and after-50 bays oi daily auppl;mentatibn we analyzed Tot and ASC levels in buccal mucosal keratinocytes. which are a good indicator of skin mxcronutrients, and determined the PROTECTION
dose
resoonse cur"e of ““B ervthema. In all three suooleTOC and ASC levels were increased, and'ihe dose response curve showed a flattenlog at hiqher UVB doses, which-was most evident in the arouo receivins TOC plus ASC. However, all differences dib noi reach statistical significance due to large interindividual variability. The data implicate that megadose antioxidant supplementation 1s presumably not a feasible approach for achievement of acute UVB photoprotection. The topical use of natural antloxidants seems nevertheless to be a promising intervention strategy in photoprotection.
mented g;oups UVB
1382 308 nm EXCIMER LASER FOR PSORIASIS B. m ‘Dept. of Dennatol , A Scent-Gyiirgyi Medical Umv , *Dept of Optics and Quantum Electronics, A. J6rsef Univ. Szeged, Hungmy 311 nm UVB phototherapy is a widely-used treatment for psoriasis. Since the biological effects of laser light differ those of mcoherent light with the same wavelength, and the wavelength ofthe 308 nm xenon chloride (X&l) excimer laser is wthm the action spectrum for the phokotherapy of psoriasa, we have mvestigafed the theraoeunc effect of XeCl laser hekt for osorxir~ Ten Caucasianoatients Pntk chronic pl$e type psoriasis, within the age mnie 24-73 (mean 48 2) ye&s were studied One (2-3 cm diameter) of tkex plaques was treated with the 308 nm X&l exclmer laser The energy of each hght Impulse was 5.5 mJ/cm’, while the duration was 15 ns. Irradmnon was started at 20-98 impulses (mean 54 6) dependmg on skin type, wth an I l-impulse increase in dose each time, with 20 impulse/second rate Treatments were repeated three times weekly. In case of 6 paoents we compared the &icacy of 3 1I nm narrow band IJVB hght with the 308 nm IJVR laser. The number of treatmenti up to complete clearance with the 3 11 nm narrow band UVB light was 29-33 (mean 30 I), while that wth the 308 nm XeCl laser was S-10 (mean 8 33) The cumulatwe doses were 26 3 l-32 15 J/cm* (mean 31 1) and 2.57-8 I I J/cm’ (mean 4 81) for the 311 nm narrow band light and the 308 nm laser, respect&y Mdd and transient hypeqgmentation was observed but no orher side-effects These results suggest that treatment with thlslaser llghtismoreeffectlvethan 311nm UVB treatment andISwell worthy ofconsideration forfuturetreatment
1383 EXTRACORPOREAL ICTCLI. B
UV-A IRRADJATION WITH CARBOXYMETHYLATED GLUCAN FROM BAKER’S YEAST. Fred Ziilli and Franz Suter. Biochemisby Department, Mibelle AG Cosmetics, Buchs, Switzerland. Glucan is a poly !3-(1,3)-linked glucopyranose of high molecular weight from the cell wall of baker’s yeast and belongs to the class of compounds known as biological response modifiers. Studies have shown that these g&an preparations activate the body’s natural defense mechanisms. We have developed a process to modify the insoluble glucan polysacchtide to carboxymethyl glucan, a water-soluble product suitable for topical applications. Our cell culture experiments showed that carboxymethylated glucau protects skin cells against the depletion of antioxidant molecules upon UV-A irradiation. In placebo controlled studies, carboxymethylated glucan at a very low concentration (0.04%) was able to protect the skin against squalene peroxidation induced by W-A irradiation. We speculate that these effects regarding UV-A protection are based on an unspecific stimulation of skin cells by carboxymethylated glucan because in vitro lipid peroxidation experiments did not reveal protecting effects of the polysaccharide.
1386 PHOTOPHERESIS
FOR CUTANEOUS T-CELL LYMPHOMA t%re,men W. Lim f. Ronaldo.
DeptofDwmatolo~y. New YorkUniversity SchofMedicine. New York. NY. USA;*Dept ofDermatology, Henry Ford Hospital. Detro,t, Ml, USA. This study rewews the experience of treatment of patients with srvthradermlc CTCL with ~~tracorooreal ohotooheresis fECPl at the New York &ran Affairs Medal Cente,/NI;U Medical Center between 9/87 and 4197. FOR” one patients received photopheresis; 25 of them fulfilled the inclusion cnterion,v3., the compledon of 2 6 cydes of phctopheresis. Skinscorewas defined as a product of s~?,,,Y and percentage of involved surface 8,ea. Complete cli”,cal ,espo”se was defined 8s disappearance of measurable disease for at least one month. and partial response was defined as 2 So% clearance of measurable d,se.se ‘0, at least one month. The oroflle Of the “adents was: 20 men. 5 women: averaae aoe: 64.2 wars: 17 p&“ts had s&e 111d,seaSe, and 8 had srage I\ldise.&. Fyvveof the’25 patients ,20%, achieved camplete clinical response. another 15 160%) had oartial ,esoo”se, and 5 120961 had no ,esoo”se. The ave,a”e tmw to achieve clinical c,ea,ance WBS 12.6 ,rangs:4-30 an* the .we,a9e time to obtain pwtml clinical response was 9.6 months lrswe: 4-17 months). Remission duration ranged from 9 to 67 mo. The average CD4lCDS ratlo in the responders was 6.5 Irange: 1.7 to 201 while in the non-responders was 11 .O (range: 1 .S to 271. At the time of maximal clina response, the ratio in the responders was 1.4 l‘a”9e 1 .O to 2.1, Side effects were minimal. Therefore, ECP IS a” sffecti”e and safe tr~afment for eryfhrodermlc CTCL. In B minorny of these patients, lt ~a” lnducs B ion9 term and complete ~llnical
&mlplete
22irange 2.510451.
,e,,l,*Sl0”.
1385 SKINPROTECIION AGAINST OXIDATIVE STRESS INDUCED BY
monrhs
months1
while inthe“an-re~,,a”derr if was
A NEW USE FOR THE ULTRVIOLET-A IRRADIATED H.~~LESS MOUSE ASSAY OF ANTI-LNFLAh&fATORY TOPJCALS. L.H. Department of Dermatology, University of Pennsylvania, Philadelphia, PA. High dose WA exposure of hairless mice provokes a ~evefe neutrophilic infiltrate in the lower dermis. Topical corticosteriods have been shown to inhibit the infiltrate in a potency r&wed manner. In this study we examined diverse topic& some of which, such as retinoids, have been claimed to have anti-inflammatory properties. Hairless mice(4igroup) weretreated topically for7 dayswiththefollowing: (tretinoin (.Ol, .02.5, .OS%), its vehicle, salicytic acid (2,and 5%) glycolic acid (Ssb), Aknemycin, Napmxen, Thiabendazole, Metrogel, Euceti and petrolatom. Isopmpyl myristate served as a non-specific hyperplasiogenic control. On the 8th day, mice were anesthetized and exposed to WA (195 J/cm’ = 3 MED) from a WASUN 3OOOlamp (340-4oOnm) on a 2 co? area of dorsal tnmk skin. The remainder of the dorsum was treated with a sunscrew. Exposed skin wan excised 24 hr post-UV, fixed for light microscopy and stained with hematoxylin and eosin. Neuwophils in the lower de& were counted in IO fields/specimen under oil immersion. UVA controls hadanaverse of 70 neutrophiWfield. Tretinoin showed a dose dependent inhibition of the infiltrate from 48 fo 82%. Inhibition by the vehicle was 10% as was fhaf by isopropyl myristate which thickened the epidermis to a similar degree as uetinom. Significant inhibition was also seen with salicyhc acid (40 and 59%), glycolic acid (@i%),Thiabcndazole (44%) Aknemycin and pevolatum (20%). Metroeel. Eucerin and Naoroxen wee ineffectne.