Acta dermato-venereologica
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Acta Derm. Venereol. · Jan 2008
Randomized Controlled Trial Comparative StudyTargeted broadband ultraviolet b phototherapy produces similar responses to targeted narrowband ultraviolet B phototherapy for vitiligo: a randomized, double-blind study.
Narrowband ultraviolet B (NB-UVB) phototherapy, with a 308-nm xenon chloride excimer laser, and targeted UVB phototherapy have produced encouraging therapeutic results for vitiligo. However, very few studies employing broadband UVB exist. Moreover, there has been no direct comparison study between broadband UVB and NB-UVB for the treatment of vitiligo. The aims of this study were to compare the repigmenting efficacy of targeted broadband UVB phototherapy with that of NB-UVB in an equi-erythemogenic manner. Twenty identical vitiliginous lesions from 10 patients were randomly allocated to receive either targeted broadband UVB or targeted NB-UVB phototherapy. UV fluences were started at 50% of the minimal erythema dose detected within the vitiliginous patches, then increased gradually, in the same manner, to ensure equi-erythemogenic comparison. Treatments were carried out twice weekly for 12 weeks. The results show that grade 1, i.e. 1-25% repigmentation, to grade 2, 26-50% repigmentation, occurred in 6 of 10 subjects. Responses in terms of repigmentation, de-pigmentation, or lack thereof, were similar between lesions receiving broadband and NB-UVB phototherapy. Onset of repigmentation occurred as early as 4 weeks of treatment in most subjects. Treatments were well tolerated, with only minimal erythema and hyperpigmentation. ⋯ The study was carried out in a small number of patients with skin types III, IV and V. The irradiation device was a targeted UVB device and thus the results may not be applicable to other light sources, such as the excimer laser or total-body irradiation cabinets. In conclusion, targeted broadband UVB produces similar clinical responses to targeted NB-UVB in the treatment of the non-segmental type of vitiligo.
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Acta Derm. Venereol. · Jan 2008
Letter Randomized Controlled TrialCalcipotriol used as monotherapy or combination therapy with betamethasone dipropionate in the treatment of nail psoriasis.
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Acta Derm. Venereol. · Jan 2008
ReviewBiopsychosocial mechanisms of chronic itch in patients with skin diseases: a review.
Itch is a major feature of many skin diseases, which adversely affects patient's quality of life. Besides disease severity, psychophysiological factors have been proposed to influence the itch sensation. In this review the evidence for a biopsychosocial model of itch is described, focusing in particular on evidence for the effects of personality characteristics, external stressors, cognitive, behavioural and social factors, and the possible mediating role of physiological processes. ⋯ Furthermore, cognitive factors, such as helplessness and worrying, and the behavioural response of scratching have been indicated as possible worsening factors. Overall, findings are in favour of a biopsychosocial model for the itch sensation. However, there is a strong need for more, methodologically sound research in order fully to understand the processes underlying the itch sensation.
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Acta Derm. Venereol. · Jan 2008
Controlled Clinical TrialOcclusive treatment enhances efficacy of tacrolimus 0.1% ointment in adult patients with vitiligo: results of a placebo-controlled 12-month prospective study.
Topical tacrolimus was recently introduced as a novel therapeutic option in vitiligo. Excellent results were seen mainly on the face and neck areas. We treated 30 adult vitiligo patients with tacrolimus 0.1% ointment twice daily, and compared the results with those of placebo ointment. ⋯ There was no significant elevation in tacrolimus blood levels, taking into account that occlusion was performed only on limited parts of the body. In conclusion, tacrolimus 0.1% ointment proved an effective and safe treatment option for adult patients with vitiligo. Beyond the face and neck areas, repigmentation could be achieved only by additional occlusion.
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Patients with acne often scratch their lesions. As scratching is also a part of the response to pruritic stimuli, this study aimed to determine whether itching accompanies acne. A total of 108 teenagers (mean age 15.8+/-1.8 years) with acne were included in the study. ⋯ Itching episodes were of short duration in most subjects (<1 min: 51.9%; up to 10 min: 38.9%) and occurred infrequently (several times a week: 24.5%; at least once a month: 30.2%; less than once a month: 37.7%). However, 31.5% of patients reported that they had used medical treatment to reduce itching due to acne lesions. We conclude that itching of mild to moderate severity is a relatively common concomitant symptom of acne lesions.