RESUMO
Guinea pigs were injected intraperitoneally with 8-methoxypsoralen (8-MOP) and afterwards the shaved right flank was irradiated with UV-A. This treatment was performed daily for 14 days. Seven days after treatment started they were immunized with ovalbumin in Freund's complete adjuvant and 7 days later skin tested with ovalbumin on the unirradiated left flank. Photochemotherapy (8-MOP plus UV-A) did not alter the total white blood cells or the proportion of lymphocytes or granulocytes. However, this treatment significantly depressed the delayed hypersensitivity reaction to ovalbumin; nonspecific inflammation, induced by intradermal turpentine, was not altered. In addition, treatment with 8-MOP alone suppressed the skin reaction to ovalbumin, but not to the same extent as treatment with 8-MOP and UV-A. 8-MOP plus UV-A had no effect on macrophage migration inhibition factor but it did significantly depress mitogen and antigen specific lymphocyte transformation.
Assuntos
Imunidade Celular , Terapia PUVA , Fotoquimioterapia , Animais , Contagem de Células Sanguíneas , Inibição de Migração Celular , Feminino , Cobaias , Hipersensibilidade Tardia , Ativação Linfocitária , Macrófagos/imunologiaRESUMO
Seventy-three patients with mycosis fungoides were treated with photochemotherapy and followed up for 2 to 39 months. Photochemotherapy produced clinical and histological clearing in a very high proportion of patients with stage 0 to II disease. The response in patients with tumours was less satisfactory, and a high proportion of these patients required local radiotherapy to resistant lesions. Maintenance treatment with photochemotherapy may keep many patients with stage 0 to II disease in remission for up to 3 years, but patients with advanced disease may relapse despite maintenance treatment. Patients with all stages of mycosis fungoides may relapse when maintenance treatment is withdrawn.
Assuntos
Furocumarinas/uso terapêutico , Micose Fungoide/tratamento farmacológico , Fotoquimioterapia , Neoplasias Cutâneas/tratamento farmacológico , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Micose Fungoide/patologiaAssuntos
Fotoquimioterapia , Psoríase/tratamento farmacológico , Terapia Ultravioleta , Animais , Catarata/induzido quimicamente , Humanos , Metoxaleno/efeitos adversos , Metoxaleno/uso terapêutico , Mutagênicos/efeitos adversos , Ratos , Dermatopatias/induzido quimicamente , Neoplasias Cutâneas/induzido quimicamenteRESUMO
A two-centre trial has been carried out on 224 patients with chronic plaque psoriasis randomly allocated to treatment with a standard dithranol regimen of 8-methoxypsoralen and long-wave ultraviolet light (P.U.V.A.). Lesions in 91% of the 113 in the P.U.V.A. group cleared satisfactorily compared with 82% of 111 in the dithranol group, but clearing took longer (34.4 +/- 1.8 S.E. days) with P.U.V.A. than with dithranol (20.4 +/- 0.9 S.E. days). P.U.V.A. treatment took less patient-time and nurse-time and was more convenient and acceptable to the patients. Patients in whom lesions had failed to clear with dithranol, and some who had needed methotrexate for control, responded satisfactorily to P.U.V.A. A few patients who had failed on P.U.V.A. were treated with dithranol and responded to it. There is a case for the use of P.U.V.A. for patients who would otherwise require methotrexate and those who cannot be managed successfully with dithranol. There is also no reason to withhold P.U.V.A. in patients of 60 years or above with chronic plaque psoriasis. However, despite its superiority in terms of cost and patient acceptability, P.U.V.A. cannot be recommended as the first line of treatment for patients with uncomplicated, dithranol-responsive plaque psoriasis until there is more information on relapse-rate and toxicity.
