Dermatomal Vitiligo: Therapeutic Implication of Dermabrasion.
Journal of Pan-Arab League of Dermatologists
Vol. 19, No. 1, February 2008 Page 31-44
Dermatomal Vitiligo: Therapeutic Implication of Dermabrasion.
Nagat S Mohammad, Maha F Elgoweini & Nouran A Khadr
Department of Dermatology and Venereology, Faculty of Medicine, Alexandria University
Comparative Study of Bath PUVA and Salt Water Bath with UVB in the Treatment of Plaque Psoriasis: Clinical and Immunohistochemical Evaluation of Ki67, CD3 and S100 Expression
Hanan M Saleh*, Nehal M Zu El-Fakkar*, Mohamed A Salam*and Nafissa M Amin**Departments of Dermatology and Venereology*and Pathology**, Faculty of Medicine Ain Shams UniversityHospital
Abstract
Background:Psoriasis is a skin inflammatory disorder with immunopathological basis. T cellsare the main cells orchestrating the sequence of events underlying the pathogenesis of this disease. Several lines of treatments are available for the treatment of this chronic disease. Avoiding the serious side effects and the frequent exacerbations are always the main targets of the authors while trying a new line of therapy. Bath PUVA was proved to be effective in the treatment of this disease, yet it carries the risk of photosensitivity. Taking a salt water bath before UVB was found to decrease the minimal erythema dose and to improve the effect UVB in the treatment of psoriasis.
Patients and methods: Thirty psoriatic patients were included in this study to compare the effect of bath PUVA and the effect of salt water bath before UVB using PASI score for clinical evaluation, CD3, S100 and Ki67 for immunohistochemical evaluation before and after treatment. Patients were compared to 10 healthy volunteers.
Results: Comparing salt water bath and UVB as a line of treatment with bath PUVA was proved to produce clinically similar effect, reflected on PASI score with no statistically significant difference (P > 0.05). Salt water bath before UVB sessions proved to decrease epidermal proliferation with decreased Ki67 to a statistically significant difference ( P < 0.05 in the epidermis and P < 0.01 in the dermis), decrease inflammatory cell infiltrate in the dermis and epidermis as evident by the decreased expression of CD3 on T cells ( P < 0.001) and decrease in the antigen presenting cells that help starting of the immunological reaction as detected by the decreased S100 expression in thedermis and normalization in the epidermis(P < 0.001) to a highly statistically significant difference in comparison with there measure before treatment.
Conclusion: Our data confirm the high efficacy of both bath PUVA and salt water bath with UVB in the treatment of Psoriasis but salt water bath with UVB helps avoidance of the side effect of systemic treatment and the photo sensitivity experienced with bath PUVA therapy
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Journal of Pan-Arab League of Dermatologists
Vol. 19, No. 1, February 2008 Page 31-44
Dermatomal Vitiligo: Therapeutic Implication of Dermabrasion.
Nagat S Mohammad, Maha F Elgoweini & Nouran A Khadr
Department of Dermatology and Venereology, Faculty of Medicine, Alexandria University
Comparative Study of Bath PUVA and Salt Water Bath with UVB in the Treatment of Plaque Psoriasis: Clinical and Immunohistochemical Evaluation of Ki67, CD3 and S100 Expression
Hanan M Saleh*, Nehal M Zu El-Fakkar*, Mohamed A Salam*and Nafissa M Amin**Departments of Dermatology and Venereology*and Pathology**, Faculty of Medicine Ain Shams UniversityHospital
Abstract
Background:Psoriasis is a skin inflammatory disorder with immunopathological basis. T cellsare the main cells orchestrating the sequence of events underlying the pathogenesis of this disease. Several lines of treatments are available for the treatment of this chronic disease. Avoiding the serious side effects and the frequent exacerbations are always the main targets of the authors while trying a new line of therapy. Bath PUVA was proved to be effective in the treatment of this disease, yet it carries the risk of photosensitivity. Taking a salt water bath before UVB was found to decrease the minimal erythema dose and to improve the effect UVB in the treatment of psoriasis.
Patients and methods: Thirty psoriatic patients were included in this study to compare the effect of bath PUVA and the effect of salt water bath before UVB using PASI score for clinical evaluation, CD3, S100 and Ki67 for immunohistochemical evaluation before and after treatment. Patients were compared to 10 healthy volunteers.
Results: Comparing salt water bath and UVB as a line of treatment with bath PUVA was proved to produce clinically similar effect, reflected on PASI score with no statistically significant difference (P > 0.05). Salt water bath before UVB sessions proved to decrease epidermal proliferation with decreased Ki67 to a statistically significant difference ( P < 0.05 in the epidermis and P < 0.01 in the dermis), decrease inflammatory cell infiltrate in the dermis and epidermis as evident by the decreased expression of CD3 on T cells ( P < 0.001) and decrease in the antigen presenting cells that help starting of the immunological reaction as detected by the decreased S100 expression in thedermis and normalization in the epidermis(P < 0.001) to a highly statistically significant difference in comparison with there measure before treatment.
Conclusion: Our data confirm the high efficacy of both bath PUVA and salt water bath with UVB in the treatment of Psoriasis but salt water bath with UVB helps avoidance of the side effect of systemic treatment and the photo sensitivity experienced with bath PUVA therapy