eISSN: 1644-4124
ISSN: 1426-3912
Central European Journal of Immunology
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vol. 37

Review papers
Role of UVA1 phototherapy in treatment of scleroderma and scleroderma-like disorders”

Agnieszka Osmola-Mańkowska
Aleksandra Dańczak-Pazdrowska
Karolina Olek-Hrab
Wojciech Silny

(Centr Eur J Immunol 2012; 37 (4): 391-398)
Online publish date: 2013/02/10
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Treatment of scleroderma and scleroderma-like diseases poses a serious challenge to contemporary dermatology due to the complexity of its pathogenesis, low incidence of the diseases and their heterogenous clinical expression. the manifestation of this autoimmune disease includes an increased production and deposition of collagen fibres types I and III in the skin and connective tissue as well as vascular alterations. Ultraviolet A1 (UVA1) phototherapy affects various stages of a morbid process in scleroderma: it inhibits inflammation and affects the consequences of it, fibrosis. Currently, UVA1 is proposed as a potential treatment and is believed to have a multifold mechanism of action. This includes, inducing apoptosis in T and B lymphocytes, inhibition of proinflammatory cytokine production and ability to induce collagenase production by fibroblasts. UVA1 irradiation may also interact with endothelial cells, promoting angiogenesis. Efficacy of high, moderate, and low doses of UVA1 was documented. Advantages of UVA1 phototherapy include the evident avoidance of systemic side effects of psoralens such as nausea and vomiting or photokeratitis as well as lower risk of phototoxic reactions with deeper penetration of radiation. Its disadvantages include high cost of equipment, thus reducing the accessibility of the treatment to specialized centres. Due to its unique mechanism of action, attempts to use UVA1 phototherapy seem justified in other rare diseases, developing with skin induration.

phototherapy, UVA1, treatment, scleroderma, morphea, lichen sclerosus, scleredema, scleromyxedema, graft-versus-host disease

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