title: Ultraviolet A1 phototherapy beyond morphea: experience in 83 patients.
abstract: OBJECTIVE
  Ultraviolet A1 (UVA1) phototherapy has been used for over 15 years in the United States, primarily for the treatment of localized sclerosis and various sclerosing disorders. The objective was to describe use of UVA1 for dermatoses beyond localized sclerosis at two academic institutions.
  
  
  METHODS
  Data from 83 patients treated with low- (20-40 J/cm(2) ), medium- (>40-80 J/cm(2) ), and high- (>80-120 J/cm(2) ) dose UVA1 phototherapy was retrospectively analyzed. The mean individual treatment dose (J/cm(2) ), the mean number of sessions, and the mean total dose (J/cm(2) ) were evaluated. Effectiveness was assessed by reviewing clinical examination notes from office visits.
  
  
  RESULTS
  Good therapeutic efficacy was seen in patients with systemic sclerosis (SS, 16 patients), graft-versus-host disease (GVHD, 25 patients), and nephrogenic systemic fibrosis (NSF, 17 patients). A statistically significant a dose-response association was observed in the cases of SS, GVHD and NSF. Likelihood of clinical improvement from UVA1 phototherapy was very likely for medium- and high-dose regimens in SS, while this level of improvement was only observed in GVHD and NSF patients receiving high-dose UVA1.
  
  
  CONCLUSIONS
  UVA1 phototherapy is effective and safe in the treatment of GVHD, NSF, SS, and mast cell disorders. High-dose regimens appear to be more effective than medium- and low-dose regimens for NSF and GVHD, while medium- and high-dose regimens outperform low-dose UVA1 in SS.
authors.affiliation: Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Connolly
authors.affiliation: Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Griffith
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Marian
authors.initials: M
authors.lastname: McEvoy
authors.affiliation: Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Henry W
authors.initials: HW
authors.lastname: Lim
mesh_terms: D004307:Dose-Response Relationship, Radiation; D005260:Female; D006086:Graft vs Host Disease / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D054989:Nephrogenic Fibrosing Dermopathy / Q000532:radiotherapy*; D011829:Radiation Dosage; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000532:radiotherapy*; D014467:Ultraviolet Therapy / Q000009:adverse effects / Q000379:methods*
keywords: UVA-1; UVA1; nephrogenic systemic fibrosis; scleroderma; ultraviolet A1