[Comparison of the minimal erythema dose for narrowband UV-B and broad spectrum UV-B using a new UV hand-held device]. / Vergleich der minimalen Erythemdosis von Schmalspektrum-UV-B- und Breitspektrum-UV-B-Strahlern mit einem neuen UV-Handgerät.

BACKGROUND: Phototherapy requires an individually adapted therapeutic regime that is based upon the minimal erythema dose for each patient. Whereas this is well established for UV-B broadband, so far no standardized equipment existed that allowed for determination of the MED for UV-B 311 nm narrowband irradiation. Thus, the starting dose for UV-B 311 nm is usually adjusted to the clinical skin type or the MED for broad-spectrum UV-B irradiation. PATIENTS AND METHODS: We determined the MED for UV-B 311 nm in a cohort of 110 healthy test persons with a newly constructed hand-held UV-light source and compared it to UV-B broadband MED. RESULTS: For UV-B broadband, the MEDs ranged from 46.2 to 210.9 mJ/cm(2) with an average value of 108.45 mJ/cm(2). For the MED of narrowband UV-B 311 nm, the values ranged from 300.9 to 1.386.0 mJ/cm(2) with an average value of 838.88 mJ/cm(2). Concerning the factor of the MED UV-B broad-spectrum related to MED UV-B 311 nm narrowband, values from 4.01 to 13.68 with a average value of 7.91 resulted. No significant differences could be detected for the MED of UV-B broad-spectrum and narrowband in correlation to age, sex or clinical skin type. CONCLUSION: Our data emphasize the presence of extensive inter-individual differences in the MED of both UV-B-spectra and point to the necessity to test patients before the first irradiation.

[Treatment of methicillin-resistant Staphylococcus aureus (MRSA) as part of biosurgical management of a chronic leg ulcer]. / Therapie eines Methicillin-resistenten Staphylococcus aureus (MRSA) im Rahmen der Behandlung eines chronischen Ulkus mittels Biochirurgie.

Colonization with methicillin-resistant Staphylococcus aureus (MRSA) strains is an increasing problem in the treatment of wounds. Only a very limited repertoire of effective treatment strategies is available, especially for outpatient care. We successfully treated a chronic leg ulcer colonized with MRSA on an ambulatory basis, using larvae of the common greenbottle fly Lucilia sericata. Whereas the proteases secreted by Lucilia sericata may lead to efficient selective necrolysis, the phenylacetate and phenylacetataldehyde may exert antimicrobial effects. Treatment with Lucilia sericata represents an effective and inexpensive treatment strategy of chronic wounds, especially when colonized with MRSA Due to the low acceptance by patients and medical stuff, it is not often employed.