Psoralen plus ultraviolet A does not increase the risk of cataracts: a 25-year prospective study.

BACKGROUND: In some animal species, exposure of the unprotected eye to psoralen plus ultraviolet A (PUVA) therapy induces lens opacities. The relevance of these animal findings to human beings is not established. However, some case reports suggest that PUVA in human beings may increase the risk of lens abnormalities. OBJECTIVE: Our aim was to evaluate any possible associations between exposure to PUVA and increased risk of ocular lens abnormalities. METHODS: Since 1977 the PUVA follow-up study has periodically monitored the ocular status of 1237 cohort members with psoriasis using structured eye examinations. In our previous report we presented data results of the first 10 years of prospective study. This report includes data from two additional cycles of eye examinations that span an additional 14 years of follow-up. RESULTS: Based on our data from the last pre-1993 to final eye examination (2004), compared with that observed for the earlier period (first ever to last pre-1993 eye examination), the age-adjusted incidence of cataract did not increase significantly (incidence rate ratio = 1.04, 95% confidence interval = 0.82-1.31). In both the univariate and multivariate analyses increasing exposure to PUVA was not associated with a higher risk of cataract. LIMITATIONS: Our cohort principally enrolled middle-aged or older patients so our data do not permit us to assess the effects of PUVA on the eyes of younger persons. CONCLUSIONS: Increasing exposure to PUVA does not increase cataract risk among persons using eye protection at the rates used in our cohort.

Association of clinical progression in classic Kaposi's sarcoma with reduction of peripheral B lymphocytes and partial increase in serum immune activation markers.

OBJECTIVE: To evaluate various immunologic markers in the peripheral blood of patients with early and advanced classic Kaposi's sarcoma (CKS). DESIGN: Cross-sectional study. SETTING: A major referral center for skin and venereal diseases. PATIENTS: Sixty-eight patients with histologically confirmed CKS staged according to a modified version of the Mitsuyasu-Groopman classification in stage I-II (cutaneous involvement only) and stage IV (skin and systemic involvement). MAIN OUTCOME MEASURES: Concentrations of neopterin and beta2-microglobulin, titer of anti-human herpesvirus 8 antibodies, number of natural killer cells, and numbers of total lymphocytes, B lymphocytes, T lymphocytes, and their subsets in peripheral blood. RESULTS: The median values of beta2-microglobulin and neopterin were elevated in patients with CKS in stage IV (median, 3.679 microg/mL [312.72 nmol/L] and 14.0 nmol/L, respectively) compared with patients in stage I-II (median, 2.406 microg/mL [204.51 nmol/L] and 6.5 nmol/L, respectively). A statistically significant reduction in total lymphocyte and B-lymphocyte counts was observed in patients with advanced-stage CKS (1679/microL and 79/microL, respectively) compared with patients in earlier stages of the disease (2142/microL and 224/microL, respectively). The human herpesvirus 8 antibody titer, determined by latent immunofluorescent assay, decreased from stage I-II to stage IV, although not at a statistically significant level (P = .14). CONCLUSION: The evolution of CKS from the early stages of the disease to the more advanced may be associated with a partial activation of the immune system and a gradual decrease in the number of total and B lymphocytes.