UVA1 Light for Scleroderma and Similar Conditions
| Status: | Terminated |
|---|---|
| Conditions: | Skin and Soft Tissue Infections, Cosmetic, Dermatology, Dermatology |
| Therapuetic Areas: | Dermatology / Plastic Surgery |
| Healthy: | No |
| Age Range: | 10 - 80 |
| Updated: | 4/21/2016 |
| Start Date: | January 1997 |
| End Date: | July 2003 |
The Effectiveness of UVA1 Irradiation in the Treatment of Skin Conditions With Altered Dermal Matrix: An Open Pilot Study
The purpose of this investigation is to evaluate the effectiveness of high-dose UVA1
irradiation in the treatment of fibrosing conditions of the skin, e.g., keloid (a thick scar
from growth of fibrous tissue), scleroderma (deposits of fibrous tissue in the skin) and
acne keloidalis nuchae (keloids on the back of the neck or hairline) old burn scars,
granuloma annulare or other similar skin conditions. This UVA1 dosing schedule has been used
successfully in Germany for various skin diseases, such as the above mentioned scleroderma.
irradiation in the treatment of fibrosing conditions of the skin, e.g., keloid (a thick scar
from growth of fibrous tissue), scleroderma (deposits of fibrous tissue in the skin) and
acne keloidalis nuchae (keloids on the back of the neck or hairline) old burn scars,
granuloma annulare or other similar skin conditions. This UVA1 dosing schedule has been used
successfully in Germany for various skin diseases, such as the above mentioned scleroderma.
Ultraviolet rays from the sun that reach the earth surface are divided into shorter
wavelength, hence high energy, UVB (290-320nm) and longer wavelength, hence low energy UVA
(320-400nm). The wavelengths of light that cause sunburn and are associated with skin cancer
causation is the high energy UVB. UVA wavelengths can be further divided into relatively
shorter wavelength, hence higher energy UVA2 (320-340nm) and longer wavelength, lower energy
UVA1 (340-400nm). Phototherapy light boxes used in our clinic for the treatment of
psoriasis, atopic dermatitis, and pruritus, as well as those used in tanning salons emit
both UVB and UVA wavelengths of light. The advantages of using UVA1 light source in the
treatment of skin conditions are 1) lack of skin cancer and sunburn causing rays (UVB) and
2) as a consequence, the ability to treat patients more safely and longer.
Keloid, scleroderma, acne keloidalis nuchae, and burn scars are all characterized by
collagenous thickening of the skin resulting in superficial and deep cutaneous sclerosis.
Treatments for these disabling conditions are inadequate at present. Recently, in
non-controlled studies, UVA1 was shown to induce improvement in patients with scleroderma,
granuloma annulare and urticaria pigmentosa (1-3). The mode of action of UVA1 treatment is
not completely understood, however, local immuno-modulation appears to be important (4).
UVA1 has also been shown to stimulate collagenase activity in a dose dependent manner in the
dermis (5,6). We postulate, therefore, that UVA1 in appropriate doses can improve these
fibrosing skin conditions safely through collagenase-mediated removal of excess dermal
collagen.
Based on the result of this pilot study, a formal controlled clinical investigation is
planned.
wavelength, hence high energy, UVB (290-320nm) and longer wavelength, hence low energy UVA
(320-400nm). The wavelengths of light that cause sunburn and are associated with skin cancer
causation is the high energy UVB. UVA wavelengths can be further divided into relatively
shorter wavelength, hence higher energy UVA2 (320-340nm) and longer wavelength, lower energy
UVA1 (340-400nm). Phototherapy light boxes used in our clinic for the treatment of
psoriasis, atopic dermatitis, and pruritus, as well as those used in tanning salons emit
both UVB and UVA wavelengths of light. The advantages of using UVA1 light source in the
treatment of skin conditions are 1) lack of skin cancer and sunburn causing rays (UVB) and
2) as a consequence, the ability to treat patients more safely and longer.
Keloid, scleroderma, acne keloidalis nuchae, and burn scars are all characterized by
collagenous thickening of the skin resulting in superficial and deep cutaneous sclerosis.
Treatments for these disabling conditions are inadequate at present. Recently, in
non-controlled studies, UVA1 was shown to induce improvement in patients with scleroderma,
granuloma annulare and urticaria pigmentosa (1-3). The mode of action of UVA1 treatment is
not completely understood, however, local immuno-modulation appears to be important (4).
UVA1 has also been shown to stimulate collagenase activity in a dose dependent manner in the
dermis (5,6). We postulate, therefore, that UVA1 in appropriate doses can improve these
fibrosing skin conditions safely through collagenase-mediated removal of excess dermal
collagen.
Based on the result of this pilot study, a formal controlled clinical investigation is
planned.
Inclusion Criteria:
- Age: 10-80 years
- Clinical diagnosis of keloid (or hypertrophic scar), scleroderma, acne keloidalis
nuchae, old burn scars, granuloma annulare, and other related conditions associated
with altered dermal matrix.
- No disease states or physical conditions which would impair evaluation of the test
site.
- Willing and able to receive UVA1 as directed in the protocol, make evaluation visits,
and follow protocol restrictions.
- Signed, written, witnessed, informed consent form.
- Must live within driving distance of Ann Arbor, Michigan.
Exclusion Criteria:
- History of photosensitivity.
- Pregnant or nursing women.
- Systemic therapy for the fibrosing skin condition within 30 days prior to study
enrollment.
- Involved in an investigational study within the previous 4 weeks.
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