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The Risk Of Photochemotherapy

G. Stüttgen
Published 1982 · Medicine

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Whether the risks of photochemotherapy outweigh its merits is a vexed and fascinating question, which is unlikely to be resolved for many years,'••'•^•'^•"'•^'•^" In the period 1969-1980 we treated 2,01 3 patients with phototherapy in Berlin; I believe that this work is germane to the continuing debate. We began using phototherapy with meladinine and UV-radiation mainly on vitiligo patients. In 1969 we included patients with diminished tolerance to sunlight. In 1971-72 we adopted the recommendation of ObersteLehn, Mortazawi and Weber, and began using 8-MOP and UV-A in local treatment of psoriasis. Since 1974-75 we practiced systemic treatment with 8-MOP, following tbe recommendations of Parrish, Fitzpatrick, and Wolff.^""''' The indications for treatment were mycosis fungoides and various forms of psoriasis, and, since 1978, physical urticaria and neurodermatitis. The risks of photochemotherapy arise from: (1) The toxic properties of 8-MOP; (2) The action of UV-A radiation; and (3) The molecular-biological effects of UV-A on 8-MOP (especially the Interaction of DNA psoralen with long wave ultraviolet, and the consequent development of monoadducts, etc) In considering these factors one must bear in mind that UV-A penetrates the epidermis, affecting the microcirculation and the flow of blood within tbe blood vessels, and that after local treatment, MOP is absorbed
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