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Journal of the American Academy of Dermatology
Volume 43, n° 4
pages 670-674 (octobre 2000)
Doi : 10.1067/mjd.2000.105165
Ultraviolet A1 (340-400 nm) phototherapy for scleroderma in systemic sclerosis

Akimichi Morita, MD, PhD a, Keiko Kobayashi, MD a, Iwao Isomura, MD a, Takuo Tsuji, MD a, Jean Krutmann, MD b
Nagoya, Japan, and Düsseldorf, Germany 
From the Department of Dermatology, Nagoya City University Medical School,a and the Department of Dermatology, Heinrich-Heine-University, Düsseldorf.b 


Background: The presence of an inflammatory infiltrate consisting of helper T cells and a dysregulated matrix metabolism leading to excessive deposition of collagen are two pathogenetic factors responsible for the developments of fibrosis and sclerosis in patients with systemic sclerosis. In previous studies, ultraviolet A1 (UVA1) radiation phototherapy was shown to deplete skin-infiltrating T cells through the induction of T-cell apoptosis and to up-regulate the expression of matrixmetalloproteinase-1 (collagenase-1) in dermal fibroblasts. Objective: Our purpose was to determine whether UVA1 phototherapy is effective for systemic sclerosis. Methods: Lesional skin on the forearms of patients with systemic sclerosis (diffuse type, n =3; limited type, n =1) was exposed to medium-dose UVA1 radiation (60 J/cm2) daily. Results: In all patients studied, UVA1 phototherapy-treated skin lesions were markedly softened after 9 to 29 exposures. Clinical improvement was associated with an increase in (1) joint passive range of motion values (P < .05), (2) skin temperature (thermography, P < .05), and (3) cutaneous elasticity (cutaneous elastometry, P < .05). Histologic evaluation of skin specimens obtained before and after UVA1 phototherapy revealed loosening of collagen bundles and the appearance of small collagen fibers. Conclusion: These studies indicate that UVA1 phototherapy is effective for patients with systemic sclerosis. (J Am Acad Dermatol 2000;43:670-4.)

The full text of this article is available in PDF format.

 Supported by grants from the Ministry of Education, Science and Culture of Japan (10670801, to A. M.) and from the Deutsche Forschungsgemeinschaft, SFB 503, Teilproject B2.
 Reprint requests: Akimichi Morita, MD, PhD, Department of Dermatology, Nagoya City University Medical School, Mizuhocho, Mizuho-ku, Nagoya 467-8601, Japan. E-mail:
 J Am Acad Dermatol 2000;43:670-4.

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