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Objective To investigate the optimal regimen of narrow-band ultraviolet B (NB-UVB) phototherapy in the treatment of chronic actinic dermatitis (CAD),and to analyze factors influencing treatment compliance.Methods Demographic data,results of photobiological tests,treatment parameters and clinical responses were collected from CAD patients who received NB-UVB phototherapy in Huashan Hospital affiliated to Fudan University from January 2008 to June 2015,and were reviewed retrospectively.Statistical analysis was done by using two independent samples t-test and chi-square test with SAS9.3 software to compare the clinical data between patients who completed and did not complete the NB-UVB phototherapy.Results A total of 79 CAD patients with Fitzpatrick skin type Ⅳ received NB-UVB phototherapy.Of these patients,61 (77％) completed the whole treatment,while 18 (23％) dropped out because of intolerance to the NB-UVB radiation.Among the 61 patients who completed the treatment,the average initial,final and cumulative radiation doses of NB-UVB were (0.08 ± 0.01) J/cm2,(0.32 ± 0.08) J/cm2and (5.9 ± 2.5) J respectively,and patients received (28 ± 8) times of treatment in average.When the radiation dose went up to 0.30 J/cm2,most skin lesions were cleared in 52 (85％) patients.A total of 19patients received phototesting again after the end of phototherapy.Among 16 patients sensitive to ultraviolet A (UVA) before the treatment,6 had normal minimal erythema dose to UVA (UVA-MED),and another 6 had improved UVA-MED after the treatment.Among 16 patients sensitive to UVB before the treatment,11 got normal UVB-MED and another 3 had improved UVB-MED after the treatment.Univariate analysis showed no significant differences in gender,age,duration of the disease,sensitivity to UVA and UVB radiation,results of photopatch test and patch test between the patients who completed and did not complete the treatment (all P ＞ 0.05).Conclusions The appropriate NB-UVB phototherapy for CAD patients should start at an initial radiation dose of 0.08 J/cm2 in spring and end at a final radiation dose of 0.30 J/cm2 for about 28 sessions,which can effectively reduce the photosensitivity to both UVA and UVB in CAD patients.Additionally,NB-UVB phototherapy can be applied in CAD patients of different gender,age,disease duration and photosensitive condition.
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Objective To estimate the effect of sun protection education on the severity and treatment of polymorphous light eruption (PLE).Methods Sixty-two patients with PLE were enrolled in this study,and randomly assigned into the control group (n =31) and intervention group (n =31) by using a random number table.Routine therapy was provided to all the subjects at their visits.The intervention group attended two lectures on sun protection at the beginning of spring and summer,and was given an education manual after each lecture.All the subjects completed a face to face interview and a questionnaire on the severity and therapy of PLE at the baseline and 12 months after enrollment.SPSS 11.5 software was used for data processing.Rank sum test,t test and chi-square test were carried out to assess the differences in the severity and treatment of PLE between the control group and intervention group as well as between pre-and post-intervention.Results The patients receiving sun protection education showed a significant decrease in the severity of PLE,including the number of months affected by PLE (t =4.611,P ＜ 0.01),number of PLE episodes (t =3.569,P ＜ 0.01),frequency of facial involvement (Z =2.369,P ＜ 0.05) and the time taken for lesions to appear after sun exposure (Z =2.650,P ＜0.01) in the year after enrollment compared with that before enrollment.Significant differences were also observed between the intervention group and control group in the number of months affected by PLE (t =3.679,P ＜ 0.01),number of PLE episodes (t =2.995,P ＜ 0.05),frequency of facial involvement (Z =2.169,P ＜ 0.05),the time taken for lesions to appear after sun exposure (Z =2.169,P ＜ 0.05) in the year after enrollment.The percentage of patients applying highly potent topical glucocorticosteroids (x2 =10.928,P ＜ 0.01)and administrating antihistamines (x2 =18.723,P ＜ 0.01) as well as the cumulative time of treatment with oral antihistamines (Z =2.656,P ＜ 0.01) were significantly reduced in the intervention group in the year after enrollment than in that before enrollment.Further more,a marked decrease was found in the percentage of patients applying topical highly potent glucocorticosteroids (x2 =4.521,P ＜ 0.05) and administrating antihistamines (x2 =10.949,P ＜0.01) as well as the cumulative time of treatment with oral antihistamines (Z =3.353,P ＜ 0.01).Conclusions Sun protection education through lectures and manuals appears to be an efficient adjuvant for the relief of PLE severity as well as for the reduction in the use of antihistamines and glucocorticosteroids,suggesting that dermatologists should pay more attention to sun protection education in the treatment of photosensitive diseases.
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Objective To evaluate skin barrier function in children with atopic dermatitis (AD) as well as healthy children from two communities in Shanghai and to assess the relationship between skin barrier function and AD severity.Methods Totally,169 children with AD and 142 healthy children aged 3-12 years were recruited from two communities (Changning Xining community and Jiading Juyuan community) in Shanghai,China.Transepidermal water loss (TEWL) and stratum corneum hydration were measured in normal appearing nonlesional skin at four body sites (dorsal and volar forearm,cheek and anterior shin) of the patients,as well as in normal skin at the same sites of the controls.AD severity was evaluated by using the severity scoring of atopic dermatitis (SCORAD) index.Results Compared with the healthy children,the patients with AD showed higher TEWL value at all of the four body sites (all P ＜ 0.05),but lower water content in stratum corneum at dorsal forearm and anterior shin (both P ＜ 0.05).In patients with AD,the SCORAD index was positively correlated with mean TEWL value,but negatively correlated with the mean water content in stratum corneum.Conclusion Skin barrier function may serve as an index for evaluating the severity of AD.
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Objective To explore the establishment of skin photoaging model and the protective effects of nitroxide tempol on skin in guinea pig. Methods The guinea pig skin photoageing model was established by using solar-simulaten radiation (SSR). Dermal structure was observed with hematoxylin-eosin staining. The structure and expression of elastic fiber were analyzed by Weigert's staining. The uhrastructure of dermal fibroblasts and elastic fiber were observed by electron microscopy. Tempol was used before each exposure at the concentration of 5 mg/ml or 0. 5 mg/ml, and the protective effects of tempol on skin were assessed. Results After seventeen weeks' exposure, there was typical "solar elastosis" damage in the upper dermis. Mature elastic fibers were severely degraded and there was large amount of elastotic material accumulated in the upper dermis. Dermal fibroblasts appeared metabolically hyperactive and mitochondria in the cells were damaged. Some cells even broke up. Tempol at the concentration of 5 mg/ml or 0. 5 mg/ml could prevent photodamage of the photoageing model in the dermis, and Tempol at the concentration of 5 mg/ml had stronger protective effects. Conclusions Guinea pig can be applied as an useful animal model of skin photoageing. Antioxidant tempol has photoprotective effects on photodamage of the photoageing model in guinea pig and can be used as an anti-photoageing agent.
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ED are correlated with the severity of CAD in a degree.
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Objective To determine the effects of Tempol, one of the nitroxides, in the presence of ultraviolet-AI (UVA1, 340 nm -400 nm) on superoxide enzyme (SOD) activity, lipid peroxidation, and expression of collagen Ⅰ, collagen Ⅲ and matrix metalloproteinases (MMP)-1, MMP-3 in human dermal fi broblasts in vitro. Methods Fibroblasts were irradiated by a single exposure to UVA1 and at the same time incubated with or without Tempol, and detected 24 h later. SOD activity and lipid peroxidation, as shown by accumulation of malondialdehyde (MDA), were detected by biochemical assay. Expression of collagen Ⅰ, collagen Ⅲ (protein levels) and MMP-1, MMP-3 (mRNA level) was examined by ELISA and semi-quantitative RT-PCR, respectively. Results A dose of 15 J/cm2 UVA1 significantly inhibited SOD activity and collagen Ⅰ , collagen Ⅲ protein levels, increased MDA level and stimulated MMP-1, MMP-3 mRNA expression (P
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Objective To determine the effects of tempol(a nitroxide), in the exposure of ultraviolet-B (UVB), on cell proliferation, superoxide enzyme (SOD) activity, lipid peroxidation, and expression of matrix metalloproteinases (MMP)-1,MMP-3 in human foreskin fibroblasts in vitro. Methods Fibroblasts were irradiated by a single exposure of 36 seconds to 40 mJ/cm 2 UVB and at the same time incubated with, or without, tempol and detected twenty-four hours later. SOD activity and lipid peroxidation,as shown by accumulation malondialdehyde (MDA) were detected by biochemical assay. Expression of MMP-1 and MMP-3 (mRNA level) were examined by Semi-quantitative RT-PCR. Results 40 mJ/cm 2 UVB significantly inhibited cell proliferation rate to (84?8)% (P
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Objective To investigate the effect of all-trans-retinoid(ATRA) on the migration of endothelial cells and the expression of gelatinases. Methods In vitro migration assay was used to determine the effect of ATRA on the endothelial cell migration induced by phorbol 12-myristate-13-acetate (PMA), semi-quantitative RT-PCR and Western blot were used to observe the effect of ATRA on the gelatinase expression at mRNA and protein levels respectively, while the proteolytic activities of gelatinases were assessed by zymography. Results The endothelial cell migration elicited by PMA was significantly inhibited when incubated with 0.1 ?mol/L, 1.0 ?mol/L and 10.0 ?mol/L ATRA. Compared with the control, the inhibition rates were (44.68 ? 7.79)%, (65.20 ? 4.59)% and (78.37 ? 2.58)%, respectively. ATRA also reduced the expression and activities of gelationases in a dose dependant manner. At 10 ?mol/L concentration, the inhibition rate of mRNA expression, protein expression and protein activities for gelatinase A was (59.39 ? 7.98)%, (78.40 ? 3.23)% and (53.02 ? 7.23)%, respectively. For gelatinase B it was (65.23 ? 3.62)%, (82.49 ? 2.88)% and (47.32 ? 7.72)%, respectively. Conclusions The expression and activities of gelatinases are downregulated in the endothelial cells when incubated with ATRA, which may be the possible mechanism of ATRA inhibiting the endothelial cell migration elicited by PMA in vitro.