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Open Access 01-12-2016 | Review

Phototherapy in Scleroderma

Authors: John Hassani, Steven R. Feldman

Published in: Dermatology and Therapy | Issue 4/2016

Abstract

Systemic and localized scleroderma are difficult to manage diseases with no accepted gold standard of therapy to date. Phototherapeutic modalities for scleroderma show promise. A PubMed search of information on phototherapy for scleroderma was conducted. The information was classified into effects on pathogenesis and clinical outcomes. Studies on photopheresis were excluded. There were no randomized, double-blind, placebo-controlled studies, and only three controlled studies. The vast majority of identified studies evaluated ultraviolet A1 (UVA1) phototherapy. More rigorous studies are needed to evaluate phototherapy in the treatment of scleroderma. Based on the limited studies available, 20–50 J/cm² of UVA1 therapy 3–4 times a week for 30 treatments is recommended.

Morgan MC, Rashid RM. The effect of phototherapy on neutrophils. Int Immunopharmacol. 2009;9(4):383–8.PubMedCrossRef

Kerr HA, Lim HW. Photobiology and phototherapeutics. Adv Dermatol. 2003;19:11–36.PubMed

Wlaschek M, Briviba K, Stricklin GP, Sies H, Scharffetter-Kochanek K. Singlet oxygen may mediate the ultraviolet A-induced synthesis of interstitial collagenase. J Invest Dermatol. 1995;104(2):194–8.PubMedCrossRef

Amat A, Rigau J, Waynant RW, Ilev IK, Tomas J, Anders JJ. Modification of the intrinsic fluorescence and the biochemical behavior of ATP after irradiation with visible and near-infrared laser light. J Photochem Photobiol B. 2005;81(1):26–32.PubMedCrossRef

Gruss C, Reed JA, Altmeyer P, McNutt NS, Kerscher M. Induction of interstitial collagenase (MMP-1) by UVA-1 phototherapy in morphea fibroblasts. Lancet. 1997;350(9087):1295–6.PubMedCrossRef

Kreuter A, Hyun J, Skrygan M, Sommer A, Bastian A, Altmeyer P, Gambichler T. Ultraviolet Al-induced downregulation of human beta-defensins and interleukin-6 and interleukin-8 correlates with clinical improvement in localized scleroderma. Br J Dermatol. 2006;155(3):600–7.PubMedCrossRef

Nisar MF, Parsons KS, Bian CX, Zhong JL. UVA irradiation induced heme oxygenase-1: a novel phototherapy for morphea. Photochem Photobiol. 2015;91(1):210–20.PubMedCrossRef

Yin L, Yamauchi R, Tsuji T, Krutmann J, Morita A. The expression of matrix metalloproteinase-1 mRNA induced by ultraviolet A1 (340–400 nm) is phototherapy relevant to the glutathione (GSH) content in skin fibroblasts of systemic sclerosis. J Dermatol. 2003;30(3):173–80.PubMedCrossRef

El-Mofty M, Mostafa W, Esmat S, Youssef R, Bousseila M, Nagi N, Shaker O, Abouzeid A. Suggested mechanisms of action of UVA phototherapy in morphea: a molecular study. Photodermatol Photoimmunol Photomed. 2004;20(2):93–100.PubMedCrossRef

10.

Hayashi S, Ikeda M, Kitamura Y, Hamasaki Y, Hatamochi A. UVA irradiation following treatment with topical 8-methoxypsoralen improves bleomycin-induced scleroderma in a mouse model, by reducing the collagen content and collagen gene expression levels in the skin. J Dermatol Sci. 2012;67(1):20–5.PubMedCrossRef

11.

Ju M, Chen K, Chang B, Gu H. UVA1 irradiation inhibits fibroblast proliferation and alleviates pathological changes of scleroderma in a mouse model. J Biomed Res. 2012;26(2):135–42.PubMedPubMedCentralCrossRef

12.

El-Mofty M, Zaher H, Bosseila M, Yousef R, Saad B. Low-dose broad-band UVA in morphea using a new method for evaluation. Photodermatol Photoimmunol Photomed. 2000;16(2):43–9.PubMedCrossRef

13.

Gambichler T, Skrygan M, Tomi NS, Altmeyer P, Kreuter A. Differential expression of decorin in localized scleroderma following ultraviolet-A1 irradiation. J Am Acad Dermatol. 2007;56(6):956–9.PubMedCrossRef

14.

Sawada H, Isogai Z, Morita A. Altered decorin expression of systemic sclerosis by UVA1 (340–400 nm) phototherapy: immunohistochemical analysis of 3 cases. BMC Dermatol. 2003;3:2.PubMedPubMedCentralCrossRef

15.

Chakraborty AK, Funasaka Y, Slominski A, Bolognia J, Sodi S, Ichihashi M, Pawelek JM. UV light and MSH receptors. Ann N Y Acad Sci. 1999;885:100–16.PubMedCrossRef

16.

Kiss M, Wlaschek M, Brenneisen P, Michel G, Hommel C, Lange TS, Peus D, Kemeny L, Dobozy A, Scharffetter-Kochanek K. Alpha-melanocyte stimulating hormone induces collagenase/matrix metalloproteinase-1 in human dermal fibroblasts. Biol Chem Hoppe Seyler. 1995;376(7):425–30.PubMedCrossRef

17.

Kreuter A, Breuckmann F, Uhle A, Brockmeyer N, Von Kobyletzki G, Freitag M, Stuecker M, Hoffmann K, Gambichler T, Altmeyer P. Low-dose UVA1 phototherapy in systemic sclerosis: effects on acrosclerosis. J Am Acad Dermatol. 2004;50(5):740–7.PubMedCrossRef

18.

Wang F, Garza LA, Cho S, Kafi R, Hammerberg C, Quan T, Hamilton T, Mayes M, Ratanatharathorn V, Voorhees JJ, et al. Effect of increased pigmentation on the antifibrotic response of human skin to UV-A1 phototherapy. Arch Dermatol. 2008;144(7):851–8.PubMedPubMedCentralCrossRef

19.

De Rie MA, Bos JD. Photochemotherapy for systemic and localized scleroderma. J Am Acad Dermatol. 2000;43(4):725–6.PubMedCrossRef

20.

Camacho NR, Sanchez JE, Martin RF, Gonzalez JR, Sanchez JL. Medium-dose UVA1 phototherapy in localized scleroderma and its effect in CD34-positive dendritic cells. J Am Acad Dermatol. 2001;45(5):697–9.PubMedCrossRef

21.

Vielhaber G, Grether-Beck S, Koch O, Johncock W, Krutmann J. Sunscreens with an absorption maximum of > or = 360 nm provide optimal protection against UVA1-induced expression of matrix metalloproteinase-1, interleukin-1, and interleukin-6 in human dermal fibroblasts. Photochem Photobiol Sci. 2006;5(3):275–82.PubMedCrossRef

22.

Nakamura T, Matsushima M, Hayashi Y, Shibasaki M, Imaizumi K, Hashimoto N, Shimokata K, Hasegawa Y, Kawabe T. Attenuation of transforming growth factor-β-stimulated collagen production in fibroblasts by quercetin-induced heme oxygenase-1. Am J Respir Cell Mol Biol. 2011;44(5):614–20.PubMedCrossRef

23.

Breuckmann F, Stuecker M, Altmeyer P, Kreuter A. Modulation of endothelial dysfunction and apoptosis: UVA1-mediated skin improvement in systemic sclerosis. Arch Dermatol Res. 2004;296(5):235–9.PubMedCrossRef

24.

Breuckmann F, Appelhans C, Bastian A, Stuecker M, Altmeyer P, Kreuter A. UVA1-induced decrease in dermal neuron-specific enolase (NSE) in acrosclerosis. Arch Dermatol Res. 2004;296(4):182–4.PubMed

25.

Bulat V, Situm M, Dediol I, Ljubicic I, Bradic L. The mechanisms of action of phototherapy in the treatment of the most common dermatoses. Coll Antropol. 2011;35(Suppl 2):147–51.PubMed

26.

Brenneisen P, Wlaschek M, Wenk J, Blaudschun R, Hinrichs R, Dissemond J, Krieg T, Scharffetter-Kochanek K. Ultraviolet-B induction of interstitial collagenase and stromelyin-1 occurs in human dermal fibroblasts via an autocrine interleukin-6-dependent loop. FEBS Lett. 1999;449(1):36–40.PubMedCrossRef

27.

Fagot D, Asselineau D, Bernerd F. Direct role of human dermal fibroblasts and indirect participation of epidermal keratinocytes in MMP-1 production after UV-B irradiation. Arch Dermatol Res. 2002;293(11):576–83.PubMedCrossRef

28.

Kondo S, Kooshesh F, Sauder DN. Penetration of keratinocyte-derived cytokines into basement membrane. J Cell Physiol. 1997;171(2):190–5.PubMedCrossRef

29.

Usmani N, Murphy A, Veale D, Goulden V, Goodfield M. Photochemotherapy for systemic sclerosis: effect on clinical and molecular markers. Clin Exp Dermatol. 2010;35(6):608–13.PubMedCrossRef

30.

Usmani N, Murphy A, Veale D, Goulden V, Goodfield M. Photochemotherapy for localized morphoea: effect on clinical and molecular markers. Clin Exp Dermatol. 2008;33(6):698–704.PubMedCrossRef

31.

Inoue T, Yamaoka T, Murota H, Yokomi A, Tanemura A, Igawa K, Tani M, Katayama I. Effective oral psoralen plus ultraviolet A therapy for digital ulcers with revascularization in systemic sclerosis. Acta Derm Venereol. 2014;94(2):250–1.PubMedCrossRef

32.

Brinckmann J, Neess CM, Gaber Y, Sobhi H, Notbohm H, Hunzelmann N, Fietzek PP, Muller PK, Risteli J, Gebker R, et al. Different pattern of collagen cross-links in two sclerotic skin diseases: lipodermatosclerosis and circumscribed scleroderma. J Invest Dermatol. 2001;117(2):269–73.PubMedCrossRef

33.

Sakakibara N, Sugano S, Morita A. Ultrastructural changes induced in cutaneous collagen by ultraviolet-A1 and psoralen plus ultraviolet A therapy in systemic sclerosis. J Dermatol. 2008;35(2):63–9.PubMedCrossRef

34.

Karrer S, Bosserhoff AK, Weiderer P, Landthaler M, Szeimies RM. Influence of 5-aminolevulinic acid and red light on collagen metabolism of human dermal fibroblasts. J Invest Dermatol. 2003;120(2):325–31.PubMedCrossRef

35.

Karrer S, Bosserhoff AK, Weiderer P, Landthaler M, Szeimies RM. Keratinocyte-derived cytokines after photodynamic therapy and their paracrine induction of matrix metalloproteinases in fibroblasts. Br J Dermatol. 2004;151(4):776–83.PubMedCrossRef

36.

Liebmann J, Born M, Kolb-Bachofen V. Blue-light irradiation regulates proliferation and differentiation in human skin cells. J Invest Dermatol. 2010;130(1):259–69.PubMedCrossRef

37.

Casara C, Eidt L, Cunha V. Prevalence study of dermatoses referred to the phototherapy unit at the Dermatology Service of the Clinics Hospital of Porto Alegre, RS, Brazil. An Bras Dermatol. 2013;88(2):211–5.PubMedPubMedCentralCrossRef

38.

Warburton KL, McPhee MJ, Savage LJ, Honan AE, Montgomery R, Ghazavi M, Torley D, Shams K, Ingram JR. Management of morphoea: results of a national survey of UK clinicians. Br J Dermatol. 2014;171(5):1243–5.PubMedCrossRef

39.

Johnson W, Jacobe H. Morphea in adults and children cohort II: patients with morphea experience delay in diagnosis and large variation in treatment. J Am Acad Dermatol. 2012;67(5):881–9.PubMedCrossRef

40.

Hawley DP, Pain CE, Baildam EM, Murphy R, Taylor AE, Foster HE. United Kingdom survey of current management of juvenile localized scleroderma. Rheumatology (Oxford). 2014;53(10):1849–54.CrossRef

41.

Strickland N, Patel G, Strickland A, Jacobe H. Attitudes and trends in the treatment of morphea: a national survey. J Am Acad Dermatol. 2015;72(4):727–8.PubMedPubMedCentralCrossRef

42.

Kerscher M, Volkenandt M, Meurer M, Lehmann P, Plewig G, Röcken M. Treatment of localised scleroderma with PUVA bath photochemotherapy. Lancet. 1994;343(8907):1233.PubMedCrossRef

43.

Kerscher M, Dirschka T, Volkenandt M. Treatment of localised scleroderma by UVA1 phototherapy. Lancet. 1995;346(8983):1166.PubMedCrossRef

44.

Kroft EB, van de Kerkhof PC, Gerritsen MJ, de Jong EM. Period of remission after treatment with UVA-1 in sclerodermic skin diseases. J Eur Acad Dermatol Venereol. 2008;22(7):839–44.PubMedCrossRef

45.

Sator PG, Radakovic S, Schulmeister K, Honigsmann H, Tanew A. Medium-dose is more effective than low-dose ultraviolet Al phototherapy for localized scleroderma as shown by 20-MHz ultrasound assessment. J Am Acad Dermatol. 2009;60(5):786–91.PubMedCrossRef

46.

Su O, Onsun N, Onay HK, Erdemoglu Y, Ozkaya DB, Cebeci F, Somay A. Effectiveness of medium-dose ultraviolet Al phototherapy in localized scleroderma. Int J Dermatol. 2011;50(8):1006–13.PubMedCrossRef

47.

Kerscher M, Volkenandt M, Gruss C, Reuther T, von Kobyletzki G, Freitag M, Dirschka T, Altmeyer P. Low-dose UVA phototherapy for treatment of localized scleroderma. J Am Acad Dermatol. 1998;38(1):21–6.PubMedCrossRef

48.

Jacobe HT, Cayce R, Nguyen J. UVA1 phototherapy is effective in darker skin: a review of 101 patients of Fitzpatrick skin types I–V. Br J Dermatol. 2008;159(3):691–6.PubMedCrossRef

49.

Connolly KL, Griffith JL, McEvoy M, Lim HW. Ultraviolet A1 phototherapy beyond morphea: experience in 83 patients. Photodermatol Photoimmunol Photomed. 2015;31(6):289–95.PubMedCrossRef

50.

Suh KS, Kang JS, Baek JW, Kim TK, Lee JW, Jeon YS, Jang MS, Kim ST. Efficacy of ultraviolet A1 phototherapy in recalcitrant skin diseases. Ann Dermatol. 2010;22(1):1–8.PubMedPubMedCentralCrossRef

51.

El-Mofty M, Mostafa W, El-Darouty M, Bosseila M, Nada H, Yousef R, Esmat S, El-Lawindy M, Assaf M, El-Enani G. Different low doses of broad-band UVA in the treatment of morphea and systemic sclerosis. Photodermatol Photoimmunol Photomed. 2004;20(3):148–56.PubMedCrossRef

52.

Vasquez R, Jabbar A, Khan F, Buethe D, Ahn C, Jacobe H. Recurrence of morphea after successful ultraviolet A1 phototherapy: a cohort study. J Am Acad Dermatol. 2014;70(3):481–8.PubMedCrossRef

53.

Ridge CA, Moktar A, Barry J, Murphy GM. Photochemotherapy and methotrexate used to treat generalized cutaneous scleroderma. J Eur Acad Dermatol Venereol. 2007;21(5):692–3.PubMed

54.

Kerscher M, Meurer M, Sander C, Volkenandt M, Lehmann P, Plewig G, Rocken M. PUVA bath photochemotherapy for localized scleroderma. Evaluation of 17 consecutive patients. Arch Dermatol. 1996;132(11):1280–2.PubMedCrossRef

55.

Newland K, Marshman G. Success treatment of post-irradiation morphoea with acitretin and narrowband UVB. Australas J Dermatol. 2012;53(2):136–8.PubMedCrossRef

56.

Buense R, Duarte IA, Bouer M. Localized scleroderma: assessment of the therapeutic response to phototherapy. An Bras Dermatol. 2012;87(1):63–9.PubMedCrossRef

57.

Barolet D. Pulsed versus continuous wave low-level light therapy on osteoarticular signs and symptoms in limited scleroderma (CREST syndrome): a case report. J Biomed Opt. 2014;19(11):118001.PubMedCrossRef

58.

Nistico SP, Saraceno R, Schipani C, Costanzo A, Chimenti S. Different applications of monochromatic excimer light in skin diseases. Photomed Laser Surg. 2009;27(4):647–54.PubMedCrossRef

59.

Kineston D, Kwan JM, Uebelhoer NS, Shumaker PR. Use of a fractional ablative 10.6-μm carbon dioxide laser in the treatment of a morphea-related contracture. Arch Dermatol. 2011;147(10):1148–50.PubMedCrossRef

60.

Comstedt LR, Svensson A, Troilius A. Improvement of microstomia in scleroderma after intense pulsed light: a case series of four patients. J Cosmet Laser Ther. 2012;14(2):102–6.PubMedCrossRef

61.

Batchelor R, Lamb S, Goulden V, Stables G, Goodfield M, Merchant W. Photodynamic therapy for the treatment of morphoea. Clin Exp Dermatol. 2008;33(5):661–3.PubMedCrossRef

62.

Breuckmann F, Gambichler T, Altmeyer P, Kreuter A. UVA/UVA1 phototherapy and PUVA photochemotherapy in connective tissue diseases and related disorders: a research based review. BMC Dermatol. 2004;4(1):11.PubMedPubMedCentralCrossRef

63.

Sacher C, Konig C, Scharffetter-Kochanek K, Krieg T, Hunzelmann N. Bullous pemphigoid in a patient treated with UVA-1 phototherapy for disseminated morphea. Dermatology. 2001;202(1):54–7.PubMedCrossRef

64.

Kreuter A, Gambichler T, Avermaete A, Jansen T, Hoffmann M, Hoffmann K, Altmeyer P, von Kobyletzki G, Bacharach-Buhles M. Combined treatment with calcipotriol ointment and low-dose ultraviolet A1 phototherapy in childhood morphea. Pediatr Dermatol. 2001;18(3):241–5.PubMedCrossRef

65.

Lam J, Polifka JE, Dohil MA. Safety of dermatologic drugs used in pregnant patients with psoriasis and other inflammatory skin diseases. J Am Acad Dermatol. 2008;59(2):295–315.PubMedCrossRef

66.

Park KK, Murase JE. Narrowband UV-B phototherapy during pregnancy and folic acid depletion. Arch Dermatol. 2012;148(1):132–3.PubMedCrossRef

67.

Borradale D, Isenring E, Hacker E, Kimlin MG. Exposure to solar ultraviolet radiation is associated with a decreased folate status in women of childbearing age. J Photochem Photobiol B. 2014;131:90–5.PubMedCrossRef

68.

Bielsa Marsol I. Update on the classification and treatment of localized scleroderma. Actas Dermosifiliogr. 2013;104(8):654–66.PubMedCrossRef

69.

Durand F, Staumont D, Bonnevalle A, Hachulla E, Hatron PY, Thomas P. Ultraviolet Al phototherapy for treatment of acrosclerosis in systemic sclerosis: controlled study with half-side comparison analysis. Photodermatol Photoimmunol Photomed. 2007;23(6):215–21.PubMedCrossRef

70.

Kreuter A, Hyun J, Stucker M, Sommer A, Altmeyer P, Gambichler T. A randomized controlled study of low-dose UVA1, medium-dose UVA1, and narrowband UVB phototherapy in the treatment of localized scleroderma. J Am Acad Dermatol. 2006;54(3):440–7.PubMedCrossRef

71.

de Rie MA, Enomoto DN, de Vries HJ, Bos JD. Evaluation of medium-dose UVA1 phototherapy in localized scleroderma with the cutometer and fast Fourier transform method. Dermatology. 2003;207(3):298–301.PubMedCrossRef

72.

Stege H, Berneburg M, Humke S, Klammer M, Grewe M, Grether-Beck S, Boedeker R, Diepgen T, Dierks K, Goerz G, et al. High-dose UVA1 radiation therapy for localized scleroderma. J Am Acad Dermatol. 1997;36(6 Pt 1):938–44.PubMedCrossRef

73.

Andres C, Kollmar A, Mempel M, Hein R, Ring J, Eberlein B. Successful ultraviolet A1 phototherapy in the treatment of localized scleroderma: a retrospective and prospective study. Br J Dermatol. 2010;162(2):445–7.PubMedCrossRef

74.

Gruss CJ, Von Kobyletzki G, Behrens-Williams SC, Lininger J, Reuther T, Kerscher M, Altmeyer P. Effects of low dose ultraviolet A-1 phototherapy on morphea. Photodermatol Photoimmunol Photomed. 2001;17(4):149–55.PubMedCrossRef

75.

Morita A, Kobayashi K, Isomura I, Tsuji T, Krutmann J. Ultraviolet A1 (340–400 nm) phototherapy for scleroderma in systemic sclerosis. J Am Acad Dermatol. 2000;43(4):670–4.PubMedCrossRef

76.

Grundmann-Kollmann M, Ochsendorf F, Zollner TM, Spieth K, Sachsenberg-Studer E, Kaufmann R, Podda M. PUVA-cream photochemotherapy for the treatment of localized scleroderma. J Am Acad Dermatol. 2000;43(4):675–8.PubMedCrossRef

77.

Hofer A, Soyer HP. Oral psoralen-UV-A for systemic scleroderma. Arch Dermatol. 1999;135(5):603–4.PubMedCrossRef

78.

Karrer S, Abels C, Landthaler M, Szeimies RM. Topical photodynamic therapy for localized scleroderma. Acta Derm Venereol. 2000;80(1):26–7.PubMedCrossRef

79.

Rose RF, Turner D, Goodfield MJ, Goulden V. Low-dose UVA1 phototherapy for proximal and acral scleroderma in systemic sclerosis. Photodermatol Photoimmunol Photomed. 2009;25(3):153–5.PubMedCrossRef

80.

Pereira N, Santiago F, Oliveira H, Figueiredo A. Low-dose UVA(1) phototherapy for scleroderma: what benefit can we expect? J Eur Acad Dermatol Venereol. 2012;26(5):619–26.PubMedCrossRef

81.

von Kobyletzki G, Uhle A, Pieck C, Hoffmann K, Altmeyer P. Acrosclerosis in patients with systemic sclerosis responds to low-dose UV-A1 phototherapy. Arch Dermatol. 2000;136(2):275–6.PubMedCrossRef

82.

Oikarinen A, Knuutinen A. Ultraviolet A sunbed used for the treatment of scleroderma. Acta Derm Venereol. 2001;81(6):432–3.PubMedCrossRef

83.

Rombold S, Lobisch K, Katzer K, Grazziotin TC, Ring J, Eberlein B. Efficacy of UVA1 phototherapy in 230 patients with various skin diseases. Photodermatol Photoimmunol Photomed. 2008;24(1):19–23.PubMedCrossRef

84.

Kreuter A, Hyun J, Skrygan M, Sommer A, Tomi NS, Breuckmann F, Altmeyer P, Gambichler T. Ultraviolet A1 phototherapy decreases inhibitory SMAD7 gene expression in localized scleroderma. Arch Dermatol Res. 2006;298(6):265–72.PubMedCrossRef

85.

Tuchinda C, Kerr HA, Taylor CR, Jacobe H, Bergamo BM, Elmets C, Rivard J, Lim HW. UVA1 phototherapy for cutaneous diseases: an experience of 92 cases in the United States. Photodermatol Photoimmunol Photomed. 2006;22(5):247–53.PubMedCrossRef

86.

Ozdemir M, Engin B, Toy H, Mevlitoglu I. Treatment of plaque-type localized scleroderma with retinoic acid and ultraviolet A plus the photosensitizer psoralen: a case series. J Eur Acad Dermatol Venereol. 2008;22(4):519–21.PubMedCrossRef

87.

Pavlotsky F, Sakka N, Lozinski A, Barzilai A. Bath psoralen-UVA photochemotherapy for localized scleroderma: experience from a single institute. Photodermatol Photoimmunol Photomed. 2013;29(5):247–52.PubMedCrossRef

88.

Morison WL. Psoralen UVA therapy for linear and generalized morphea. J Am Acad Dermatol. 1997;37(4):657–9.PubMedCrossRef

89.

Pasic A, Ceovic R, Lipozencic J, Husar K, Susic SM, Skerlev M, Hrsan D. Phototherapy in pediatric patients. Pediatr Dermatol. 2003;20(1):71–7.PubMedCrossRef

90.

von Felbert V, Kernland-Lang K, Hoffmann G, Wienert V, Simon D, Hunziker T. Irradiation with water-filtered infrared A plus visible light improves cutaneous scleroderma lesions in a series of cases. Dermatology. 2011;222(4):347–57.PubMedCrossRef

91.

Kauer F, Simon JC, Sticherling M. Nodular morphea. Dermatology. 2009;218(1):63–6.PubMedCrossRef

92.

Uchiyama M, Okubo Y, Kawashima H, Yamamoto K, Mitsuhashi Y, Tsuboi R. Case of localized scleroderma successfully treated with bath psoralen and ultraviolet A therapy. J Dermatol. 2010;37(1):75–80.PubMedCrossRef

93.

Morita A, Sakakibara S, Sakakibara N, Yamauchi R, Tsuji T. Successful treatment of systemic sclerosis with topical PUVA. J Rheumatol. 1995;22(12):2361–5.PubMed

94.

Mohanna M, Distler O, Sprott H, Kündig T, French LE, Hofbauer G. Skin lesions in anti-Pm-Scl-70 positive systemic sclerosis-dermatomyositis overlap syndrome improve during local PUVA phototherapy. Eur J Dermatol. 2013;23(5):730–1.PubMed

95.

Kanekura T, Fukumaru S, Matsushita S, Terasaki K, Mizoguchi S, Kanzaki T. Successful treatment of scleroderma with PUVA therapy. J Dermatol. 1996;23(7):455–9.PubMedCrossRef

96.

García-Bustínduy M, Noda A, Sánchez R, González de Mesa MJ, Guimerá F, García-Montelongo R. PUVA therapy in localized scleroderma. J Eur Acad Dermatol Venereol. 1998;10(3):283–4.PubMedCrossRef

97.

Todd DJ, Askari A, Ektaish E. PUVA therapy for disabling pansclerotic morphoea of children. Br J Dermatol. 1998;138(1):201–2.PubMedCrossRef

98.

Baum S, Pavlotsky F, Shpiro D, Trau H. PUVA treatment in sclerodermatoid spectrum of dermatologic diseases: our initial experience. Isr Med Assoc J. 2004;6(9):563–4.PubMed

99.

Rose RF, Goodfield MJ. Combining PUVA therapy with systemic immunosuppression to treat progressive diffuse morphoea. Clin Exp Dermatol. 2005;30(3):226–8.PubMedCrossRef

100.

Gambichler T, Kreuter A, Rotterdam S, Altmeyer P, Hoffmann K. Linear scleroderma 'en coup de sabre' treated with topical calcipotriol and cream psoralen plus ultraviolet A. J Eur Acad Dermatol Venereol. 2003;17(5):601–2.PubMedCrossRef

101.

Aragane Y, Kawada A, Maeda A, Isogai R, Isogai N, Tezuka T. Disseminated scleroderma of a Japanese patient successfully treated with bath PUVA photochemotherapy. J Cutan Med Surg. 2001;5(2):135–9.PubMedCrossRef

102.

Yamaguchi K, Takeuchi I, Yoshii N, Gushi A, Kanekura T, Kanzaki T. The discrepancy in hardness between clinical and histopathological findings in localized scleroderma treated with PUVA. J Dermatol. 1998;25(8):544–6.PubMedCrossRef

103.

Wollina U, Looks A, Uhlemann C, Wollina K. Pansclerotic morphea of childhood-follow-up over 6 years. Pediatr Dermatol. 1999;16(3):245–7.PubMedCrossRef

104.

Lim D, Johnston S, Novakovic L, Fearfield L. Radiation-induced morphoea treated with UVA-1 phototherapy. Clin Exp Dermatol. 2014;39(5):612–5.PubMedCrossRef

105.

Scharffetter-Kochanek K, Goldermann R, Lehmann P, Holzle E, Goerz G. PUVA therapy in disabling pansclerotic morphoea of children. Br J Dermatol. 1995;132(5):830–1.PubMedCrossRef

106.

Yildirim M, Baysal V, Aridogan BC, Kesici D, Erturan I. Pansclerotic morphea treated with UVA: a case report. J Dermatol. 2003;30(8):625–7.PubMedCrossRef

107.

Tewari A, Garibaldinos T, Lai-Cheong J, Groves R, Sarkany R, Branislav Novakovic L. Successful treatment of microstomia with UVA1 phototherapy in systemic sclerosis. Photodermatol Photoimmunol Photomed. 2011;27(2):113–4.PubMedCrossRef

108.

Forsea AM, Cretu AN, Ionescu R, Giurcaneanu C. Disabling pansclerotic morphea of childhood–unusual case and management challenges. J Med Life. 2008;1(3):348–54.PubMed

109.

Herzinger T, Prinz JC, Röcken M. Pansclerotic morphea of the head. Arch Dermatol. 2008;144(1):125–6.PubMedCrossRef

110.

Gruss C, Stucker M, Kobyletzki G, Schreiber D, Altmeyer P, Kerscher M. Low dose UVA1 phototherapy in disabling pansclerotic morphoea of childhood. Br J Dermatol. 1997;136(2):293–4.PubMedCrossRef

111.

Steger JW, Matthews JH. UVA therapy for scleroderma. J Am Acad Dermatol. 1999;40(5 Pt 1):787–8.PubMedCrossRef

112.

Brownell I, Soter NA, Franks AG Jr. Familial linear scleroderma (en coup de sabre) responsive to antimalarials and narrowband ultraviolet B therapy. Dermatol Online J. 2007;13(1):11.PubMed

113.

Cho S, Choi MJ, Zheng Z, Goo B, Kim DY, Cho SB. Clinical effects of non-ablative and ablative fractional lasers on various hair disorders: a case series of 17 patients. J Cosmet Laser Ther. 2013;15(2):74–9.PubMedCrossRef

114.

Eisen D, Alster TS. Use of a 585 nm pulsed dye laser for the treatment of morphea. Dermatol Surg. 2002;28(7):615–6.PubMed

Title: Phototherapy in Scleroderma
Authors: John Hassani
Steven R. Feldman
Publication date: 01-12-2016
Publisher: Springer Healthcare
Published in: Dermatology and Therapy / Issue 4/2016
Print ISSN: 2193-8210
Electronic ISSN: 2190-9172
DOI: https://doi.org/10.1007/s13555-016-0136-3

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