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Psoriasis Therapy: The Effect of UV Radiation on Sensitization to Mechlorethamine

Psoriasis Therapy: The Effect of UV Radiation on Sensitization to Mechlorethamine Abstract • A study was performed to determine the effect of UV-B radiation on the sensitization of patients to topically applied mechlorethamine hydrochloride. Patients with widespread psoriasis were randomized into two groups. One group was given six daily treatments of one minimal erythemal dose (MErD) prior to starting daily applications of a 0.02% mechlorethamine ointment and, thereafter, one MErD weekly; the other group was given daily applications of mechlorethamine but received no UV-B. The improvement of psoriasis was monitored by a severity score system and patients were treated for 30 days, or until contact dermatitis occurred. The addition of UV-B to topical applications of mechlorethamine reduced the incidence of allergic contact dermatitis to mechlorethamine from 64% to 22%. In those sensitized to mechlorethamine, the time required for sensitization to develop was increased from 14 to 23 days by UV-B therapy. (Arch Dermatol 1983;119:117-121) References 1. Epstein JR Jr, Ugel AR: Effects of topical mechlorethamine on skin lesions of psoriasis . Arch Dermatol 1970;102:504-506.Crossref 2. Mandy S, Taylor JR, Halprin K: Topically applied mechlorethamine in the treatment of psoriasis . Arch Dermatol 1971;103:272-276.Crossref 3. Taylor JR, Halprin KM: Topical use of mechlorethamine in the treatment of psoriasis . Arch Dermatol 1972;106:362-364.Crossref 4. Van Scott EJ, Reinertson RP: Morphologic and physiologic effects of chemotherapeutic agents in psoriasis . J Invest Dermatol 1959;33:357-362.Crossref 5. Van Scott EJ, Yu RJ: Antimitotic, antigenic and structural relationships of nitrogen mustard and its homologues . J Invest Dermatol 1974;62:378-383.Crossref 6. Baer RL, Michaelides P, Prestia AE: Failure to induce immune tolerance to nitrogen mustard: Intravenous administration preceding topical use in patients with psoriasis . J Invest Dermatol 1972;58:1-4.Crossref 7. Breza TS, Kechijian P, Taylor JR: Mechlorethamine in psoriasis: Further attempts to induce immunological tolerance . Arch Dermatol 1975;111:1438-1439.Crossref 8. Fisher MS, Kripke ML: Systemic alteration induced in mice by ultraviolet light irradiation and its relationship to ultraviolet carcinogenesis . Proc Natl Acad Sci USA 1977;74:1688-1692.Crossref 9. Fisher MS, Kripke ML: Further studies on the tumor-specific suppressor cells induced by ultraviolet radiation . J Immunol 1978;121:1139-1144. 10. Toews GB, Bergstresser PR, Streilein JW, et al: Epidermal Langerhans cell density determines whether contact hypersensitivity or unresponsiveness follows skin painting with DNFB . J Immunol 1980;124:445-453. 11. Taylor JR, Halprin KM, Levine V, et al: Mechlorethamine hydrochloride solutions and ointments: Prolonged stability and biological activity . Arch Dermatol 1980;116:783-785.Crossref 12. Witten VH: A folding ultraviolet light box . Arch Dermatol 1973;107:716.Crossref 13. Frost P, Horwitz SN, Caputo R, et al: Tar-gel phototherapy for psoriasis: Combined therapy with suberythemogenic doses of fluorescent sunlamp ultraviolet radiation . Arch Dermatol 1979;115:840-846.Crossref 14. Weinstein GD, Frost P: Abnormal cell proliferation in psoriasis . J Invest Dermatol 1968;50:254-259. 15. Madison JF, Haserick JR: Topically applied mechlorethamine on 12 dermatoses . Arch Dermatol 1962;86:663-667.Crossref 16. Haniszko J, Suskind RR: The effect of ultraviolet radiation on experimental cutaneous sensitization in guinea pigs . J Invest Dermatol 1963;40:183-191. 17. Morrison WL, Parrish JA, Woehler ME, et al: The influence of ultraviolet radiation on allergic contact dermatitis in the guinea pig: I. UVB radiation . Br J Dermatol 1981;104:161-164.Crossref 18. O'Dell BL, Jessen T, Becker LE, et al: Diminished immune response in sun-damaged skin . Arch Dermatol 1980;116:559-561.Crossref 19. Kripke ML, Fisher MS: Immunologic parameters of ultraviolet carcinogenesis . JNCI 1976;57:211-215. 20. Horowitz S, Cripps D, Hong R: Selective T-cell killing of human lymphocytes by ultraviolet radiation . Cell Immunol 1974;14:80-86.Crossref 21. Levis WR, Lincoln PM, Dattner AM: Effect of ultraviolet light on dinitrochlorobenzene: Specific antigen presenting function . J Immunol 1978;121:1496-1500. 22. Shelley WB, Juhlin L: Lahgerhans cells form a reticuloepithelial trap for external contact antigens . Nature 1976;261:46-47.Crossref 23. Silberberg I: Ultrastructural studies of Langerhans' cells in contact sensitive and primary irritant reactions to mercuric chloride . Clin Res 1971;19:715. 24. Rowden G: Immuno-electron microscopic studies of surface receptors and antigens of human Langerhans cells . Br J Dermatol 1977;97:593-608.Crossref 25. Stingl G, Katz SI, Shevach EM, et al: Detection of Ia antigens on Langerhans cells in guinea pig skin . J Immunol 1978;120:570-578. 26. Stingl G, Katz SI, Clement L, et al: Immunologic functions of Ia-bearing epidermal Langerhans cells . J Immunol 1978;121:2005-2013. 27. Aberer W, Schuler G, Stingl G, et al: Ultraviolet light depletes surface markers of Langerhans cells . J Invest Dermatol 1981;76:202-210.Crossref 28. Halprin KM, Comeford M, Presser SE, et al: Ultraviolet light treatment delays contact sensitization to nitrogen mustard . Br J Dermatol 1981;105:71-76.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Psoriasis Therapy: The Effect of UV Radiation on Sensitization to Mechlorethamine

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1983.01650260025010
Publisher site
See Article on Publisher Site

Abstract

Abstract • A study was performed to determine the effect of UV-B radiation on the sensitization of patients to topically applied mechlorethamine hydrochloride. Patients with widespread psoriasis were randomized into two groups. One group was given six daily treatments of one minimal erythemal dose (MErD) prior to starting daily applications of a 0.02% mechlorethamine ointment and, thereafter, one MErD weekly; the other group was given daily applications of mechlorethamine but received no UV-B. The improvement of psoriasis was monitored by a severity score system and patients were treated for 30 days, or until contact dermatitis occurred. The addition of UV-B to topical applications of mechlorethamine reduced the incidence of allergic contact dermatitis to mechlorethamine from 64% to 22%. In those sensitized to mechlorethamine, the time required for sensitization to develop was increased from 14 to 23 days by UV-B therapy. (Arch Dermatol 1983;119:117-121) References 1. Epstein JR Jr, Ugel AR: Effects of topical mechlorethamine on skin lesions of psoriasis . Arch Dermatol 1970;102:504-506.Crossref 2. Mandy S, Taylor JR, Halprin K: Topically applied mechlorethamine in the treatment of psoriasis . Arch Dermatol 1971;103:272-276.Crossref 3. Taylor JR, Halprin KM: Topical use of mechlorethamine in the treatment of psoriasis . Arch Dermatol 1972;106:362-364.Crossref 4. Van Scott EJ, Reinertson RP: Morphologic and physiologic effects of chemotherapeutic agents in psoriasis . J Invest Dermatol 1959;33:357-362.Crossref 5. Van Scott EJ, Yu RJ: Antimitotic, antigenic and structural relationships of nitrogen mustard and its homologues . J Invest Dermatol 1974;62:378-383.Crossref 6. Baer RL, Michaelides P, Prestia AE: Failure to induce immune tolerance to nitrogen mustard: Intravenous administration preceding topical use in patients with psoriasis . J Invest Dermatol 1972;58:1-4.Crossref 7. Breza TS, Kechijian P, Taylor JR: Mechlorethamine in psoriasis: Further attempts to induce immunological tolerance . Arch Dermatol 1975;111:1438-1439.Crossref 8. Fisher MS, Kripke ML: Systemic alteration induced in mice by ultraviolet light irradiation and its relationship to ultraviolet carcinogenesis . Proc Natl Acad Sci USA 1977;74:1688-1692.Crossref 9. Fisher MS, Kripke ML: Further studies on the tumor-specific suppressor cells induced by ultraviolet radiation . J Immunol 1978;121:1139-1144. 10. Toews GB, Bergstresser PR, Streilein JW, et al: Epidermal Langerhans cell density determines whether contact hypersensitivity or unresponsiveness follows skin painting with DNFB . J Immunol 1980;124:445-453. 11. Taylor JR, Halprin KM, Levine V, et al: Mechlorethamine hydrochloride solutions and ointments: Prolonged stability and biological activity . Arch Dermatol 1980;116:783-785.Crossref 12. Witten VH: A folding ultraviolet light box . Arch Dermatol 1973;107:716.Crossref 13. Frost P, Horwitz SN, Caputo R, et al: Tar-gel phototherapy for psoriasis: Combined therapy with suberythemogenic doses of fluorescent sunlamp ultraviolet radiation . Arch Dermatol 1979;115:840-846.Crossref 14. Weinstein GD, Frost P: Abnormal cell proliferation in psoriasis . J Invest Dermatol 1968;50:254-259. 15. Madison JF, Haserick JR: Topically applied mechlorethamine on 12 dermatoses . Arch Dermatol 1962;86:663-667.Crossref 16. Haniszko J, Suskind RR: The effect of ultraviolet radiation on experimental cutaneous sensitization in guinea pigs . J Invest Dermatol 1963;40:183-191. 17. Morrison WL, Parrish JA, Woehler ME, et al: The influence of ultraviolet radiation on allergic contact dermatitis in the guinea pig: I. UVB radiation . Br J Dermatol 1981;104:161-164.Crossref 18. O'Dell BL, Jessen T, Becker LE, et al: Diminished immune response in sun-damaged skin . Arch Dermatol 1980;116:559-561.Crossref 19. Kripke ML, Fisher MS: Immunologic parameters of ultraviolet carcinogenesis . JNCI 1976;57:211-215. 20. Horowitz S, Cripps D, Hong R: Selective T-cell killing of human lymphocytes by ultraviolet radiation . Cell Immunol 1974;14:80-86.Crossref 21. Levis WR, Lincoln PM, Dattner AM: Effect of ultraviolet light on dinitrochlorobenzene: Specific antigen presenting function . J Immunol 1978;121:1496-1500. 22. Shelley WB, Juhlin L: Lahgerhans cells form a reticuloepithelial trap for external contact antigens . Nature 1976;261:46-47.Crossref 23. Silberberg I: Ultrastructural studies of Langerhans' cells in contact sensitive and primary irritant reactions to mercuric chloride . Clin Res 1971;19:715. 24. Rowden G: Immuno-electron microscopic studies of surface receptors and antigens of human Langerhans cells . Br J Dermatol 1977;97:593-608.Crossref 25. Stingl G, Katz SI, Shevach EM, et al: Detection of Ia antigens on Langerhans cells in guinea pig skin . J Immunol 1978;120:570-578. 26. Stingl G, Katz SI, Clement L, et al: Immunologic functions of Ia-bearing epidermal Langerhans cells . J Immunol 1978;121:2005-2013. 27. Aberer W, Schuler G, Stingl G, et al: Ultraviolet light depletes surface markers of Langerhans cells . J Invest Dermatol 1981;76:202-210.Crossref 28. Halprin KM, Comeford M, Presser SE, et al: Ultraviolet light treatment delays contact sensitization to nitrogen mustard . Br J Dermatol 1981;105:71-76.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Feb 1, 1983

References