Abstract:
:Photochemotherapy with methoxsalen (8-methoxypsoralen) and long wavelength ultraviolet (UV) radiation (referred to as 'PUVA' for psoralen plus UVA) is commonly used to treat psoriasis and vitiligo. These vastly different diseases respond to the therapy by different mechanisms even though the immediate effects of the therapy--the photomodification of cellular biomolecules--is the same for each. Because psoriasis is not cured by PUVA, patients receive many treatments over their lifetime and have a significantly increased risk for the development of skin cancers (primarily squamous cell carcinomas). In this article the basic aspects of psoralen photobiology are reviewed briefly. Several recent studies describing the incidence of skin cancer in UVA treated psoriasis cohorts are comparatively reviewed. In addition the impact of the analysis of mutations in the tumor suppressor gene, p53, are summarized. An unexpected mutation spectrum (very few PUVA type T-->A transversions and frequent UVB solar signature C-->T transitions) suggest that effects other than direct DNA photoadduct formation may be at play. These analyses suggest that it may be possible to improve the therapeutic efficacy of PUVA by a careful evaluation of the mode of delivery. In this review the science behind PUVA is summarized. In addition, the incidence of skin cancer as a long term consequence of repeated treatments is surveyed. To relate clinical observations to molecular events, the nature of p53 mutations found in skin cancers from psoriasis patients is also analyzed. Finally some suggestions for improving the delivery of PUVA therapy are presented.
journal_name
Am J Clin Dermatoljournal_title
American journal of clinical dermatologyauthors
Gasparro FPdoi
10.2165/00128071-200001060-00002subject
Has Abstractpub_date
2000-11-01 00:00:00pages
337-48issue
6eissn
1175-0561issn
1179-1888journal_volume
1pub_type
杂志文章,评审abstract::Postinflammatory hyperpigmentation (PIH) is a reactive hypermelanosis and sequela of a variety of inflammatory skin conditions. PIH can have a negative impact on a patient's quality of life, particularly for darker-skinned patients. Studies show that dyschromias, including PIH, are one of the most common presenting co...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/11536930-000000000-00000
更新日期:2011-04-01 00:00:00
abstract::Darier's disease is a rare cutaneous disease with an autosomal dominant mode of inheritance. Greasy papules and plaques arise on the seborrheic areas and in the flexures and almost all patients have nail abnormalities. Acantholysis and dyskeratosis are the typical histological findings. The underlying defect is a resu...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/00128071-200304020-00003
更新日期:2003-01-01 00:00:00
abstract::The family of toll-like receptors (TLRs) plays a central role in the cutaneous immune defense system. To date, different TLRs have been found on several major cell populations of the skin, such as keratinocytes, fibroblasts, antigen-presenting cells, and melanocytes. Activation of TLRs leads, via different intracellul...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/11311110-000000000-00000
更新日期:2010-01-01 00:00:00
abstract::The incidence of basal cell carcinoma is rapidly increasing and a number of treatment modalities are available. Treatment of basal cell carcinoma includes both surgical and nonsurgical approaches, some of which are traditional, and others experimental. The treatment modality utilized is dependent on both the tumor typ...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/00128071-200203040-00003
更新日期:2002-01-01 00:00:00
abstract::We report a typical case of hematidrosis in a Chinese girl who had experienced frequent bleeding episodes for more than 3 years. During hospitalization, spontaneous bleeding from her intact skin was witnessed by our staff on more than 20 occasions. Characteristically, bloody droplets from the intact skin contained all...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章
doi:10.2165/11531690-000000000-00000
更新日期:2010-12-01 00:00:00
abstract::The dermis normally directs all phases of skin wound healing following tissue trauma or disease. However, in chronic wounds, the dermal matrix is insufficient to stimulate healing and assistance by external factors is needed for wound closure. Although the concept of the extracellular matrix directing wound healing is...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/00128071-200708020-00001
更新日期:2007-01-01 00:00:00
abstract::A 46-year-old man developed Stevens-Johnson syndrome and toxic epidermal necrolysis overlap, with severe localized denudation of the skin on the head and neck, following radiotherapy and oral temozolomide therapy for cranial glioblastoma multiforme. He also had a primary malignant fibrous histiocytoma of the thigh tha...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章
doi:10.2165/00128071-200910040-00007
更新日期:2009-01-01 00:00:00
abstract::Occupational contact dermatitis (OCD) represents 90 to 95% of all occupational dermatoses. The incidence rate of OCD is estimated to be around 0.5 to 1.9 cases per full-time worker per year. However, epidemiologic data are lacking and incidence is probably underestimated, especially in the US. Over the past 20 years, ...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/00128071-200102060-00002
更新日期:2001-01-01 00:00:00
abstract::Mycobacterial organisms have re-emerged as an important cause of infectious disease worldwide. Both tuberculosis and nontuberculous mycobacterial infections remain endemic in many parts of the world and are becoming more common in patients with iatrogenic immunosuppression and HIV infection. The nontuberculous mycobac...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/00128071-200910050-00001
更新日期:2009-01-01 00:00:00
abstract::The treatment of cutaneous T cell lymphoma (CTCL), which includes mycosis fungoides and Sezary syndrome, has been in a state of continual change over recent decades, as new therapies are constantly emerging in the search for more effective treatments for the disease. However, prognosis and survival of patients with CT...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/00128071-200203030-00006
更新日期:2002-01-01 00:00:00
abstract::Eruptive melanocytic nevi (EMN) is a phenomenon characterized by the sudden onset of nevi. Our objective was to compile all published reports of EMN to identify possible precipitating factors and to evaluate the clinical appearance and course. We conducted a systematic bibliographic search and selected 93 articles, re...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.1007/s40257-019-00444-8
更新日期:2019-10-01 00:00:00
abstract::Autoimmune bullous diseases (AIBD), including pemphigus, bullous pemphigoid, epidermolysis bullosa acquisita, mucous membrane pemphigoid, and pemphigoid gestationis, pose significant therapeutic challenges, especially in pregnant and post-partum breastfeeding patients or those planning to conceive. Data on the safety ...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.1007/s40257-018-0342-0
更新日期:2018-06-01 00:00:00
abstract::Hyperhidrosis is a common and distressing condition involving increased production of sweat. A variety of treatment modalities are used to try to control or reduce sweating. Sweat is secreted by eccrine glands innervated by cholinergic fibers from the sympathetic nervous system. Primary hyperhidrosis most commonly aff...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/00128071-200304100-00003
更新日期:2003-01-01 00:00:00
abstract::The connection between the brain and the skin is more than a physiologic fact. Skin conditions can impose great effects on every field in the patients' lives. Reciprocally, skin diseases can be evoked by psychological problems. A psychodermatology clinic is the format that enables dermatology patients to receive a com...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章
doi:10.2165/11630950-000000000-00000
更新日期:2012-04-01 00:00:00
abstract::Skin disorders are the most common adverse reactions attributed to drugs. Any skin disorder can be imitated, induced or aggravated by drugs. To help you keep up-to-date with the very latest skin reactions occurring with both new and established drugs, this section of the journal brings you information selected from th...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/00128071-200203070-00009
更新日期:2002-01-01 00:00:00
abstract::Topical retapamulin (Altabax, Altargo) is the first pleuromutilin antibacterial approved for the treatment of uncomplicated superficial skin infections caused by Staphylococcus aureus (excluding methicillin-resistant S. aureus [MRSA]) and Streptococcus pyogenes in patients aged > or = 9 months. In the EU, retapamulin ...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章
doi:10.2165/0128071-200809060-00010
更新日期:2008-01-01 00:00:00
abstract::Genital herpes, an incurable viral disease that can have a devastating impact on affected patients, is a serious public health concern affecting one in four Americans. Episodic treatment with nucleoside analogs for 3-5 days is the most common method of treatment; however, since maximum viral replication occurs within ...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,随机对照试验,评审
doi:10.2165/00128071-200607040-00001
更新日期:2006-01-01 00:00:00
abstract::Vulvar lichen sclerosus is an important skin disease that is common in women in their 50 s and beyond; however, it can also affect females of any age, including children. If not treated, it has the potential to cause significant and permanent scarring and deformity of the vulvar structure. In addition, if untreated, i...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.1007/s40257-018-0364-7
更新日期:2018-10-01 00:00:00
abstract::After a marked decline in the number of syphilis cases in the context of AIDS prevention campaigns, a significant increase has been observed in states of the former Soviet Union since 1994. In recent years, outbreaks have also been reported in the US, Canada, and several European countries. The current epidemic in the...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/00128071-200607050-00003
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Methotrexate (MTX) is an effective treatment for psoriasis but its use is limited by its toxicity. Folate supplementation can be used to reduce the adverse effects of MTX, though this may impact efficacy. The frequency of folic acid supplementation is not well characterized. PURPOSE:The objective of this st...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.1007/s40257-013-0017-9
更新日期:2013-06-01 00:00:00
abstract::Our ability to successfully treat patients with moderate to severe psoriasis has improved significantly over the last several years with the development of more targeted therapies. IL-17A, a member of the IL-17 family of interleukins, is involved in regulating the innate and adaptive immune systems and has been identi...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.1007/s40257-015-0162-4
更新日期:2016-02-01 00:00:00
abstract::Diagnosing acne is easy. However, treatment must be adapted to the type and severity of acne, and must also take into account the impact of acne on patients' quality of life. As there is not always a correlation between the severity of acne and its impact on quality of life, it can be helpful for the dermatologist to ...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/00128071-200607020-00003
更新日期:2006-01-01 00:00:00
abstract::This review summarizes results from major recent trials regarding novel therapeutic agents in melanoma. The topics discussed include targeted therapy with BRAF (V-RAF murine sarcoma viral oncogene homolog B) inhibitors (vemurafenib and dabrafenib), MEK (mitogen-activated protein kinase kinase) inhibitors (trametinib),...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.1007/s40257-014-0083-7
更新日期:2014-08-01 00:00:00
abstract::Skin disorders are the most common adverse reactions attributed to drugs. Any skin disorder can be imitated, induced or aggravated by drugs. To help you keep up-to-date with the very latest skin reactions occurring with both new and established drugs, this section of the journal brings you information selected from th...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章
doi:10.2165/00128071-200304050-00006
更新日期:2003-01-01 00:00:00
abstract::In women, acne can be successfully treated with oral contraceptives. This article focuses on the results of clinical studies on the treatment of acne with oral contraceptives. From the literature, 12 such studies could be traced over the last 10 years. Most of the studies were multicenter, randomized, and double blind...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/00128071-200405060-00008
更新日期:2004-01-01 00:00:00
abstract::Birt-Hogg-Dubé syndrome (BHD) is an autosomal dominant genodermatosis with malignant potential characterized by cutaneous and extracutaneous stigmata. Aberrations in the folliculin (FLCN) gene, which is located on chromosome 17, have been discovered in individuals with this condition. Over 150 unique mutations have be...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.1007/s40257-017-0307-8
更新日期:2018-02-01 00:00:00
abstract::Itch, also known as pruritus, is the major symptom in skin diseases with a variety of etiologies and pathophysiologies. Significant progress has been achieved in understanding the pathophysiology of itch in the last 5 years. Neurophysiological experiments in humans and animals have revealed that itch is carried by spe...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/00128071-200304090-00004
更新日期:2003-01-01 00:00:00
abstract::Topical therapy is one of the foundations of dermatology. The vehicles used to deliver topical therapy have considerable impact on efficacy. The vehicle can have direct effects on disease; it can impact the delivery of the active drug, and its characteristics affect patient compliance. While the physical chemistry of ...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章
doi:10.2165/00128071-200304040-00001
更新日期:2003-01-01 00:00:00
abstract::Halobetasol propionate (HP) 0.5% ointment and cream are class I topical corticosteroids. We review the efficacy and tolerability of HP for treatment of plaque psoriasis in the English language literature. The efficacy of HP ointment and cream is consistently superior to other super-potent topical corticosteroids. Loca...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/00128071-200506050-00004
更新日期:2005-01-01 00:00:00
abstract::Ultrapotent topical corticosteroids are the mainstay of psoriasis treatment, used either alone or in combination with a topical vitamin D analog. Traditionally used in an ointment vehicle for psoriasis, clobetasol propionate 0.05% is also available in spray, foam, lotion, and shampoo formulations, which may provide fo...
journal_title:American journal of clinical dermatology
pub_type: 杂志文章,评审
doi:10.2165/11311020-000000000-00000
更新日期:2009-01-01 00:00:00