Different low doses of broad-band UVA in the treatment of morphea and systemic sclerosis.
BACKGROUND
Numerous treatment modalities, some with potentially hazardous side effects, are currently used for morphea (M) and systemic sclerosis (SS) with limited success. Low-dose ultraviolet A (UVA) phototherapy (20 J/cm(2)) was found to be highly effective for sclerotic patches, even in patients with advanced and rapidly evolving lesions.


OBJECTIVE
To determine the effectiveness of different low doses of UVA in treating patients with M and SS.


METHODS
Sixty-three patients complaining of M and 15 patients complaining of SS received 20 sessions of UVA (320-400 nm) each. Patients were divided randomly into three groups that received 5, 10 and 20 J/cm(2), with cumulative UVA doses of 100, 200, and 400 J/cm(2), respectively. The efficacy of therapy was judged clinically (by sequential inspection and palpation) and histopathologically by morphometry in M cases.


RESULTS
Obvious clinical improvement, with no comparable differences between various low UVA doses, was noted in patients with M and SS, accompanied by histopathological changes towards normalization of collagen.


CONCLUSIONS
After 20 sessions, it appears that lower doses of UVA (5, 10 J/cm(2)) are as beneficial as the relatively higher dose (20 J/cm(2)) in the treatment of M and SS.
El-Mofty
M
M
Department of Dermatology, Phototherapy Unit, Faculty of Medicine, Cairo University, Egypt.
Mostafa
W
W
El-Darouty
M
M
Bosseila
M
M
Nada
H
H
Yousef
R
R
Esmat
S
S
El-Lawindy
M
M
Assaf
M
M
El-Enani
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D012594:Scleroderma, Localized / Q000473:pathology / Q000628:therapy*; D012598:Sclerosis / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D014467:Ultraviolet Therapy