Ghodsi Seyyede Zahra; Bahar Babak; Balighi Kamran; Ranjkesh Mohammad Reza; Toosi Siavash
Volume 11, Issue 4 , 2008, , Pages 137-142
Abstract
Background: Chronic graft versus host disease (ch.GVHD) is the most frequent late complication after allogenic stem-cell transplantation. Systemic immunosuppressive agents are usually required to control the disease. Psoralen plus UVA (PUVA) has been used for the treatment of ch.GVHD with variable beneficial ...
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Background: Chronic graft versus host disease (ch.GVHD) is the most frequent late complication after allogenic stem-cell transplantation. Systemic immunosuppressive agents are usually required to control the disease. Psoralen plus UVA (PUVA) has been used for the treatment of ch.GVHD with variable beneficial effects. The objective of this study was to assess the efficacy and safety of a relatively lower dose of oral psoralen compared with previous reports, for the treatment of ch.GVHD patients with PUVA.Methods: Eleven patients who received allogenic bone marrow transplantation and had severe progressive ch.GVHD that was unresponsive to conventional immunosuppressive treatments were treated with oral 8-methoxypsoralen (0.2 mg/kg, up to 10 mg) two hours before exposure to UVA.Results: The patients received a median of 43 treatments (range: 18 to 72). Mean cumulative dose of UVA was 200.5 J/cm2 (range, 116.5-306.5 J/cm2). In four of the 11 patients, there was a complete resolution of cutaneous ch.GVHD and the remaining seven patients achieved partial response with PUVA treatment. Complete and partial remission was observed in four and six patients with lichenoid lesions, respectively, but all of the four patients with sclerodermoid GVHD showed partial response to PUVA treatment. We observed no side effects like phototoxicity, nausea and vomiting, and exacerbation of GVHD. Liver enzymes raised in five patients, causing no significant morbidity for them.Conclusion: Low-dose psoralen plus UVA can be a safe and effective therapy for chronic cutaneous GVHD. Although the number of treatments and total cumulative exposure to UVA was rather high in our study, we observed no phototoxic reaction or severe irreversible liver damage due to phototherapy, which may be because of a relatively lower dose of methoxsalen used in our patients. Psoralen plus UVA is effective particularly in lichenoid GVHD lesions but sclerodermoid lesions may also benefit from this therapy.
Ehsani Amir Hooshang; Toosi Siavash; Noormohamadpour Pedram; Hosseini Mahboubeh; Nazeman Leila
Volume 11, Issue 4 , 2008, , Pages 143-146
Abstract
Background: Pityriasis rosea is an inflammatory skin disorder with a known response to erythromycin. Considering similarities between erythromycin and azithromycin and lesser adverse effects of the latter, in a pilot study, we gave azithromycin to seven patients with pityriasis rosea and observed a noticeable ...
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Background: Pityriasis rosea is an inflammatory skin disorder with a known response to erythromycin. Considering similarities between erythromycin and azithromycin and lesser adverse effects of the latter, in a pilot study, we gave azithromycin to seven patients with pityriasis rosea and observed a noticeable improvement. The aim of this study was to evaluate the efficacy of azithromycin in patients with pityriasis rosea.Methods: A double-blind, placebo-controlled clinical trial was performed in our clinic. Sixty patients over a period of 20 months were alternatively assigned to the treatment group or the placebo group. Patients in the treatment group received azithromycin, 250 mg/day, for 14 days. The response was categorized as complete response, partial response, or no response. All patients were followed up for 2 months.Results: Age at presentation, sex, and average duration of the disease were comparable in both groups. Complete response was observed in 19 patients (63.3 %) in the treatment group and two in the placebo group (p<0.0001).Conclusion: Oral azithromycin is effective in treating patients with pityriasis rosea.
Esmaili Nafiseh; Hallaji Zahra; Ehsani Amirhoushang; Tork Ali Naser; Robati RezaMahmood; Toosi Siavash; Zahrian Fatemeh; Maarefat Afsaneh
Volume 10, Issue 2 , 2007, , Pages 100-104
Abstract
Background and aim: Psoriasis is one of the most common inflammatory skin disorders with a genetic background. Several treatment modalities have been used, including systemic and bath PUVA. The aim of this study was to evaluate the efficacy of systemic and bath PUVA in the treatment of psoriasis in Razi ...
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Background and aim: Psoriasis is one of the most common inflammatory skin disorders with a genetic background. Several treatment modalities have been used, including systemic and bath PUVA. The aim of this study was to evaluate the efficacy of systemic and bath PUVA in the treatment of psoriasis in Razi Hospital.Materials and methods: This retrospective database study was done in Razi Hospital and the records of 390 psoriatic patients referred to phototherapy unit in 1999-2003 were studied. One hundred and forty nine patients were treated with systemic and 238 patients with bath PUVA.Results: The most common form of psoriasis was the plaque type and the majority of patients were male. Complete remission of disease was achieved in 20.1% of systemic PUVA and 17.2% of bath PUVA patients, usually after 20-29 sessions of phototherapy. The mean cumulative UVA dose for complete remission was 233.46 and 108.79 J/cm2 in systemic and bath PUVA groups, respectively. Relapse occurred in 33.3% and 17.07% of patients achieving complete remission in systemic and bath PUVA groups, respectively. Erythema was the most common side effect in both groups.Conclusion: Both systemic and bath PUVA are efficacious in the treatment of psoriasis. The total UVA dose needed for complete clearance was higher in systemic PUVA and relapse occurred more frequently in this group.
