title: Low-dose UVA1 phototherapy in systemic sclerosis: effects on acrosclerosis.
abstract: BACKGROUND
  Increased collagen synthesis, vascular damage, and T-lymphocytic infiltration contribute to the development of systemic sclerosis. Preliminary studies revealed the effectiveness of low-dose UVA1 phototherapy in acrosclerosis.
  
  
  OBJECTIVE
  We sought to confirm data of a pilot study revealing the efficacy of low-dose UVA1 irradiation in acrosclerosis in a larger number of patients.
  
  
  METHODS
  Symptoms of 18 patients receiving low-dose UVA1 phototherapy were evaluated clinically and biometrically in an open, nonrandomized study. A number of pretherapeutic and posttherapeutic biopsy specimens were tested immunohistochemically for matrix-metalloproteinase-1.
  
  
  RESULTS
  UVA1 irradiation led to softening of former stiffness reflected by a significant decrease of the hand score, increase of total skin distension, and reduction of skin thickness. Posttherapeutically, matrix-metalloproteinase-1 immunolabeling revealed a significant dermal elevation of collagenase.
  
  
  CONCLUSIONS
  Low-dose UVA1 phototherapy is a capable treatment option for acrosclerosis. Its beneficial effect may be mediated by the induction of collagenases and a reduction of collagen deposition and cellular infiltration.
authors.affiliation: Department of Dermatology and Allergology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kreuter
authors.forename: Frank
authors.initials: F
authors.lastname: Breuckmann
authors.forename: Andrea
authors.initials: A
authors.lastname: Uhle
authors.forename: Norbert
authors.initials: N
authors.lastname: Brockmeyer
authors.forename: Gregor
authors.initials: G
authors.lastname: Von Kobyletzki
authors.forename: Marcus
authors.initials: M
authors.lastname: Freitag
authors.forename: Markus
authors.initials: M
authors.lastname: Stuecker
authors.forename: Klaus
authors.initials: K
authors.lastname: Hoffmann
authors.forename: Thilo
authors.initials: T
authors.lastname: Gambichler
authors.forename: Peter
authors.initials: P
authors.lastname: Altmeyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017364:Collagenases / Q000032:analysis; D005260:Female; D006229:Hand Dermatoses / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D020781:Matrix Metalloproteinase 1 / Q000032:analysis; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012595:Scleroderma, Systemic / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy*; D012867:Skin / Q000378:metabolism / Q000473:pathology; D014463:Ultrasonography; D014467:Ultraviolet Therapy
chemical_list: D017364:Collagenases; D020781:Matrix Metalloproteinase 1