title: 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/cm(2) four times a week for 10 weeks. Forty phototherapy sessions resulted in a cumulative dose of 800 J/cm(2) 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.
authors: Department of Dermatology, Ruhr-University Bochum, Bochum, Germany. a.kreuter@derma.de
authors: A
authors: A
authors: Kreuter
authors: T
authors: T
authors: Gambichler
authors: A
authors: A
authors: Avermaete
authors: T
authors: T
authors: Jansen
authors: M
authors: M
authors: Hoffmann
authors: K
authors: K
authors: Hoffmann
authors: P
authors: P
authors: Altmeyer
authors: G
authors: G
authors: von Kobyletzki
authors: M
authors: M
authors: Bacharach-Buhles
mesh_terms: D000293:Adolescent; D002117:Calcitriol / Q000008:administration & dosage* / Q000031:analogs & derivatives; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003879:Dermatologic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D009824:Ointments; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D012594:Scleroderma, Localized / Q000473:pathology / Q000628:therapy*; D012867:Skin / Q000473:pathology; D014467:Ultraviolet Therapy
chemical_list: D003879:Dermatologic Agents; D009824:Ointments; C055085:calcipotriene; D002117:Calcitriol