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Solar ultraviolet irradiance over a Mediterranean area
L,etters to the Editor
leading to iatrogenic revelation of KS. A correlation has been reported in cases of patients with temporal arteritis or dermatomyositis and in renal transplant recipients who experienced KS remission when corticosteroid and immunosuppressive therapy were reduced or stopped [3,4]. Satta et al. suggest that gold salts may be responsible in the two cases they report. We have described one case of RA in which longstanding regression of KS occured when sulfhydry1 compounds were discontinued [5]. We believe that it is correct to establish a correlation between RA, immunosuppressive therapy and the onset of KS. The reversibility of KS on withdrawal of treatments justifies careful clinical and immunological monitoring of these patients and considerations of adjustments of immunosuppressive agents. J.P. Larbre&*
111Satta R, Cottoni F, Contu L, Mulargia M, Montesu MA.
PI
[31
[41
[51
Kaposi’s sarcoma and rheumatoid arthritis: a possible immunogenic and drug interaction, J Eur Acad Dermatol Venereal 1995;5:269-272. Casoli P, Tumiati B. Kaposi’s sarcoma, rheumatoid arthritis and immunosuppressive and/or corticosteroid therapy. .I Rheumatol 1992;19:13-16. Leung F, Fam AG, Osoba D. Kaposi’s sarcoma complicating corticosteroid therapy for temporal arteritis. Am J Med 1981;71:320-322. Weiss VC, Serushan M. Kaposi’s sarcoma in a patient with dermatomyositis receiving immunosuppressive therapy. Arch Dermatol 1982;118:183-185. Larbre JP, Nicolas IF, Collet P, Larbre B, Llorca G. Kaposi’s sarcoma in a patient with rheumatoid arthritis. Possible responsibility of captopril in the development of lesions. J Rheumatol 1991;18:476-477.
J.F. Nicolasb, G. Llorca’ * Corresponding author
aService de Rhumatologie, Centre hospitalier Lyon Sud, 69310 Pierre-Bbnite, France bINSERM U SO,Faculte’ Alexis Carrel, Universite Claude Bernard Lyon I, Lyon, France
Solar ultraviolet area
irradiance
over a Mediterranean
To the Editor: Few studies have been undertaken to measure UV irradiation reaching the earth [l-3]. We have investigated the intensity and seasonal variations of solar UVB and UVA irradiance on a Mediterranean area located in the South of Italy. Measurements were carried out during a period of three years (October 1991-October 1994) in the Dermatology Department of Naples University located 300 meters above sea level. At the Naples latitude (40”15’15” North) the solar declination angle is 72” on 21st of June and 25” on 21st of December . Direct UVB and UVA reaching the earth were measured daily at noon by a radiometer-photometer (Oriel Corporation, CN, USA: model IL 1350) equipped with two different probes (for detection of UVB and UVA) whose spectral responses ranged from 290 to 400 nm. It was placed on a tripod and pointed directly towards the sun. The results obtained are shown in Figs. 1 and 2
PZI: SO926-9959(96)00600-9
and Table 1. The data are expressed as mean daily solar radiation values for a month and as maximum peak registered each month. The data show that the minimum values in the UVB range were registered in December (mean monthly data: 0.046 mw/cm2) with the maximum values in June (0.14 mW/cm2). In the UVA range the minimum values were registered in January (0.94 mW/cm2) with the maximum values in June (2.48 mW/cm2). oct1991-et.1994
mWlcm2
3.5 ,
0’
Jan
I
I
Feb
Mar
Apr
May
June July hg lnmlll
Sepl Oci
Nw
Dee
Fig. 1. Daily UVA radiation over Naples city. Mean monthly data and maximum monthly peak, October 1991 October 1994.
Letters to the Editor Oct. 1901 -Oct. 19&l
mWla+ 0.2 ,
Table I I
Both UVB and UVA maximum monthly peak and monthly data (October 1991 - October 1994)
OJ Jan
Feb
Mar
Apr
May
June July Aug month
*Madtumma7thlype&(meanofthrwyears)
Sept Cd
Nov
UVA maximum monthly peak (mean of 3 years) (mW/cm’)
UVB maximum monthly peak (mean of 3 years) (mW/cm*)
UVA mean monthly data (mW/cm*)
UVB mean monthly data (mW/cm’)
January February March April May June July August September October November December
1.59 2.11 2.31 3.14 3.13 3.09 3.00 2.58 2.51 2.04 1.67 1.54
0.08 0.09 0.12 0.15 0.17 0.17 0.18 0.14 0.11 0.08 0.06 0.06
0.94 1.12 1.49 1.93 2.27 2.48 2.27 1.97 1.46 1.33 1.12 1.97
0.051 0.064 0.084 0.098 0.122 0.140 0.130 0.100 0.080 0.063 0.051 0.046
Ccc
++deanmonthlydata
Fig. 2. Daily UVB radiation over Naples city. Mean monthly data and maximum monthly peak, October 1991 October 1994.
In a previous study carried out in the Milan area (Northern Italy) [2] the UVB and UVA radiation annual trend were similar to ours; absolute values, to the contrary, were about half ours in both the UVB and the UVA ranges. The difference is probably due to both the different latitude (45” North for Milan and 40” North for Naples) and the different altitude (our measurements were taken at 300 meters above sea level). Our results will be useful in surveillance of photodermatoses in our country. Since the occurrence of polymorphic light eruption is common during the spring [4] (May and June), months with the highest h-radiance values, we think that it would be useful to phototest patients with UVB and UVA doses almost equivalent to the dose that a subject receives during 2 h solar exposure at midday. Another consequence of the high UVB and UVA irradiance in spring and summer, would be the possible use of sunlight (heliotherapy) in the treatment of certain dermatosis, such as psoriasis and vitiligo. G. Monfrecola*,
Month
surements of solar UVB and UVA radiation at latitude 70” North. Photodermatology 1984;1:252-254. 121Pigatto PD. Bicardi AS, Albertalli MC, Legori A, Altomare GF, Finzi AF. Changes in solar energy reaching the Earth: a study of total solar UVA and UVB radiation in a highly polluted Northern Italian area. J Eur Acad Dermatol Venereol 1992;1:291-296. [31 Kligman LH. Full spectrum solar radiation as a cause of dermal photodamage: UVB to infrared. Acta Derm Venereol 1987;134(Suppl):5341. [41 Holzle F, Plewig G, Hofmann G, Roser-Maass E. Polymorphous light eruption. J Am Acad Dermatol 1982;7:11 l125.
L. Casula, E.M. Procaccini
Department of Dermatology, Universiry “Federico II”, V. Pansini, 5, 80131 Naples, Italy
* Corresponding author. PII: SO926-9959(97)00603-4
[l] Midelfart K, Moseng D, Kavli G, Volden G. One-year mea
Acral erythema and intrahepatic 54uorouracil infusion To the Editor: 5Fluorouracil (5-FU) is a fluoropyrimidin with antitumoral activity against many
solid tumours. Continuous intrahepatic infusion is a useful alternative to intravenous therapy in patients with hepatic metastases. Because at least 50% of 5FU are cleared in their first pass through the liver, systemic toxicity with this form of therapy is mild,
leading to iatrogenic revelation of KS. A correlation has been reported in cases of patients with temporal arteritis or dermatomyositis and in renal transplant recipients who experienced KS remission when corticosteroid and immunosuppressive therapy were reduced or stopped [3,4]. Satta et al. suggest that gold salts may be responsible in the two cases they report. We have described one case of RA in which longstanding regression of KS occured when sulfhydry1 compounds were discontinued [5]. We believe that it is correct to establish a correlation between RA, immunosuppressive therapy and the onset of KS. The reversibility of KS on withdrawal of treatments justifies careful clinical and immunological monitoring of these patients and considerations of adjustments of immunosuppressive agents. J.P. Larbre&*
111Satta R, Cottoni F, Contu L, Mulargia M, Montesu MA.
PI
[31
[41
[51
Kaposi’s sarcoma and rheumatoid arthritis: a possible immunogenic and drug interaction, J Eur Acad Dermatol Venereal 1995;5:269-272. Casoli P, Tumiati B. Kaposi’s sarcoma, rheumatoid arthritis and immunosuppressive and/or corticosteroid therapy. .I Rheumatol 1992;19:13-16. Leung F, Fam AG, Osoba D. Kaposi’s sarcoma complicating corticosteroid therapy for temporal arteritis. Am J Med 1981;71:320-322. Weiss VC, Serushan M. Kaposi’s sarcoma in a patient with dermatomyositis receiving immunosuppressive therapy. Arch Dermatol 1982;118:183-185. Larbre JP, Nicolas IF, Collet P, Larbre B, Llorca G. Kaposi’s sarcoma in a patient with rheumatoid arthritis. Possible responsibility of captopril in the development of lesions. J Rheumatol 1991;18:476-477.
J.F. Nicolasb, G. Llorca’ * Corresponding author
aService de Rhumatologie, Centre hospitalier Lyon Sud, 69310 Pierre-Bbnite, France bINSERM U SO,Faculte’ Alexis Carrel, Universite Claude Bernard Lyon I, Lyon, France
Solar ultraviolet area
irradiance
over a Mediterranean
To the Editor: Few studies have been undertaken to measure UV irradiation reaching the earth [l-3]. We have investigated the intensity and seasonal variations of solar UVB and UVA irradiance on a Mediterranean area located in the South of Italy. Measurements were carried out during a period of three years (October 1991-October 1994) in the Dermatology Department of Naples University located 300 meters above sea level. At the Naples latitude (40”15’15” North) the solar declination angle is 72” on 21st of June and 25” on 21st of December . Direct UVB and UVA reaching the earth were measured daily at noon by a radiometer-photometer (Oriel Corporation, CN, USA: model IL 1350) equipped with two different probes (for detection of UVB and UVA) whose spectral responses ranged from 290 to 400 nm. It was placed on a tripod and pointed directly towards the sun. The results obtained are shown in Figs. 1 and 2
PZI: SO926-9959(96)00600-9
and Table 1. The data are expressed as mean daily solar radiation values for a month and as maximum peak registered each month. The data show that the minimum values in the UVB range were registered in December (mean monthly data: 0.046 mw/cm2) with the maximum values in June (0.14 mW/cm2). In the UVA range the minimum values were registered in January (0.94 mW/cm2) with the maximum values in June (2.48 mW/cm2). oct1991-et.1994
mWlcm2
3.5 ,
0’
Jan
I
I
Feb
Mar
Apr
May
June July hg lnmlll
Sepl Oci
Nw
Dee
Fig. 1. Daily UVA radiation over Naples city. Mean monthly data and maximum monthly peak, October 1991 October 1994.
Letters to the Editor Oct. 1901 -Oct. 19&l
mWla+ 0.2 ,
Table I I
Both UVB and UVA maximum monthly peak and monthly data (October 1991 - October 1994)
OJ Jan
Feb
Mar
Apr
May
June July Aug month
*Madtumma7thlype&(meanofthrwyears)
Sept Cd
Nov
UVA maximum monthly peak (mean of 3 years) (mW/cm’)
UVB maximum monthly peak (mean of 3 years) (mW/cm*)
UVA mean monthly data (mW/cm*)
UVB mean monthly data (mW/cm’)
January February March April May June July August September October November December
1.59 2.11 2.31 3.14 3.13 3.09 3.00 2.58 2.51 2.04 1.67 1.54
0.08 0.09 0.12 0.15 0.17 0.17 0.18 0.14 0.11 0.08 0.06 0.06
0.94 1.12 1.49 1.93 2.27 2.48 2.27 1.97 1.46 1.33 1.12 1.97
0.051 0.064 0.084 0.098 0.122 0.140 0.130 0.100 0.080 0.063 0.051 0.046
Ccc
++deanmonthlydata
Fig. 2. Daily UVB radiation over Naples city. Mean monthly data and maximum monthly peak, October 1991 October 1994.
In a previous study carried out in the Milan area (Northern Italy) [2] the UVB and UVA radiation annual trend were similar to ours; absolute values, to the contrary, were about half ours in both the UVB and the UVA ranges. The difference is probably due to both the different latitude (45” North for Milan and 40” North for Naples) and the different altitude (our measurements were taken at 300 meters above sea level). Our results will be useful in surveillance of photodermatoses in our country. Since the occurrence of polymorphic light eruption is common during the spring [4] (May and June), months with the highest h-radiance values, we think that it would be useful to phototest patients with UVB and UVA doses almost equivalent to the dose that a subject receives during 2 h solar exposure at midday. Another consequence of the high UVB and UVA irradiance in spring and summer, would be the possible use of sunlight (heliotherapy) in the treatment of certain dermatosis, such as psoriasis and vitiligo. G. Monfrecola*,
Month
surements of solar UVB and UVA radiation at latitude 70” North. Photodermatology 1984;1:252-254. 121Pigatto PD. Bicardi AS, Albertalli MC, Legori A, Altomare GF, Finzi AF. Changes in solar energy reaching the Earth: a study of total solar UVA and UVB radiation in a highly polluted Northern Italian area. J Eur Acad Dermatol Venereol 1992;1:291-296. [31 Kligman LH. Full spectrum solar radiation as a cause of dermal photodamage: UVB to infrared. Acta Derm Venereol 1987;134(Suppl):5341. [41 Holzle F, Plewig G, Hofmann G, Roser-Maass E. Polymorphous light eruption. J Am Acad Dermatol 1982;7:11 l125.
L. Casula, E.M. Procaccini
Department of Dermatology, Universiry “Federico II”, V. Pansini, 5, 80131 Naples, Italy
* Corresponding author. PII: SO926-9959(97)00603-4
[l] Midelfart K, Moseng D, Kavli G, Volden G. One-year mea
Acral erythema and intrahepatic 54uorouracil infusion To the Editor: 5Fluorouracil (5-FU) is a fluoropyrimidin with antitumoral activity against many
solid tumours. Continuous intrahepatic infusion is a useful alternative to intravenous therapy in patients with hepatic metastases. Because at least 50% of 5FU are cleared in their first pass through the liver, systemic toxicity with this form of therapy is mild,