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Effect of increased pigmentation on the antifibrotic response of human skin to UV-A1 phototherapy

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dc.contributor.authorWang, Frank-
dc.contributor.authorGarza, Luis A-
dc.contributor.authorCho, Soyun-
dc.contributor.authorKafi, Reza-
dc.contributor.authorHammerberg, Craig-
dc.contributor.authorQuan, Taihao-
dc.contributor.authorHamilton, Ted-
dc.contributor.authorMayes, Maureen-
dc.contributor.authorRatanatharathorn, Voravit-
dc.contributor.authorVoorhees, John J-
dc.contributor.authorFisher, Gary J-
dc.contributor.authorKang, Sewon-
dc.date.accessioned2010-06-07T05:57:13Z-
dc.date.available2010-06-07T05:57:13Z-
dc.date.issued2008-07-23-
dc.identifier.citationArch Dermatol. 2008;144(7):851-858en
dc.identifier.issn1538-3652 (Electronic)-
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18645136-
dc.identifier.urihttp://archderm.ama-assn.org/cgi/reprint/144/7/851.pdf-
dc.identifier.urihttps://hdl.handle.net/10371/67549-
dc.description.abstractOBJECTIVE: To investigate the efficacy, potential limitations, and biological mechanisms of UV-A1 phototherapy for skin sclerosis due to collagen deposition disorders. DESIGN: Before-and-after trial of UV-A1 irradiation of sclerotic skin; in vivo biochemical analyses after UV-A1 irradiation of normal skin. SETTING: Academic referral center. PARTICIPANTS: Patients with morphea/scleroderma or sclerodermoid graft-vs-host disease and volunteers without skin disease. Intervention Sclerotic skin was treated with high-dose (130 J/cm(2); n = 12) or medium-dose (65 J/cm(2); n = 6) UV-A1 phototherapy 3 times per week for 14 weeks; normal skin was treated with UV-A1 irradiation at various doses and frequencies, with biopsies performed afterwards. MAIN OUTCOME MEASURES: In sclerotic skin, induration was clinically assessed using a scoring scale. In normal skin, quantitative polymerase chain reaction was used to assess antifibrotic responses, defined as decreased type I and type III procollagen and increased matrix metalloproteinase levels. RESULTS: In patients with sclerotic skin treated with high-dose UV-A1 irradiation, clinical scores for induration modestly decreased. To investigate what factors prevented further improvement (ie, complete clearance), normal skin with light pigmentation was exposed to UV-A1 irradiation (70-150 J/cm(2)) and was assessed for antifibrotic responses. A single high-dose exposure (110-150 J/cm(2)) elicited substantial antifibrotic responses and induced skin darkening. This skin darkening attenuated responses to subsequent UV-A1 exposures and was dose dependent. Thus, to minimize skin darkening, additional patients with sclerotic skin were treated with medium-dose UV-A1 phototherapy, which was no less effective than high-dose therapy. CONCLUSION: Clinical responses of sclerotic skin to UV-A1 phototherapy were modest because of UV-A1-induced skin darkening, which is photoprotective and attenuates antifibrotic responses. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00129415.en
dc.language.isoenen
dc.publisherAmerican Medical Associationen
dc.subjectCollagen Type I/genetics/metabolismen
dc.subjectCollagen Type III/genetics/metabolismen
dc.subjectDose-Response Relationship, Radiationen
dc.subjectHyperpigmentation/*etiology/pathologyen
dc.subjectMatrix Metalloproteinases/genetics/metabolismen
dc.subjectPolymerase Chain Reactionen
dc.subjectRNA, Messenger/analysisen
dc.subjectRadiation Dosageen
dc.subjectScleroderma, Localized/pathology/*radiotherapyen
dc.subjectSeverity of Illness Indexen
dc.subjectSkin/*radiation effectsen
dc.subjectTreatment Outcomeen
dc.subjectUltraviolet Raysen
dc.subjectUltraviolet Therapy/*adverse effectsen
dc.titleEffect of increased pigmentation on the antifibrotic response of human skin to UV-A1 phototherapyen
dc.typeArticleen
dc.contributor.AlternativeAuthor조소연-
dc.contributor.AlternativeAuthor강세원-
dc.identifier.doi10.1001/archderm.144.7.851-
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Dermatology (피부과학전공)Journal Papers (저널논문_피부과학전공)
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