TY - JOUR
T1 - UV-A1 therapy for nephrogenic systemic fibrosis
AU - Tran, Kien T.
AU - Prather, Heidi B.
AU - Cockerell, Clay J.
AU - Jacobe, Heidi
PY - 2009/10
Y1 - 2009/10
N2 - Background: Nephrogenic systemic fibrosis (NSF) is a rare sclerosing skin condition associated with endstage renal disease and gadolinium exposure. Therapy for NSF is challenging, with few options other than preventing exposure to gadolinium and improving renal function through transplant. However, in some cases neither of these options is tenable. We report the successful use of UV-A1 phototherapy in 4 patients with NSF. Observations: Four patients with NSF were treated with UV-A1 phototherapy at a tertiary medical center from 2005 through 2007. To our knowledge, it is unique to this series that all patients were receiving hemodialysis before, during, and after therapy with UV-A1. All experienced improvement in the degree of induration, and 2 experienced improvement in mobility of the hands and legs. Total treatments ranged from 22 treatments (with a cumulative dose of 1855 J/cm2) to 50 treatments (total UV-A1 exposure, 3850 J/cm2). No adverse events were observed. Conclusions: Although no patient had complete resolution of indurated plaques, the improvement was substantial. For 2 patients, it resulted in a resumption of hand and leg mobility. As a result, UV-A1 therapy may represent a treatment for NSF when kidney transplantation is not an option or is delayed. Limitations of this study include the lack of a controlled trial, lack of quantification of gadolinium levels within tissue, and the lack of a defined grading scale for NSF severity.
AB - Background: Nephrogenic systemic fibrosis (NSF) is a rare sclerosing skin condition associated with endstage renal disease and gadolinium exposure. Therapy for NSF is challenging, with few options other than preventing exposure to gadolinium and improving renal function through transplant. However, in some cases neither of these options is tenable. We report the successful use of UV-A1 phototherapy in 4 patients with NSF. Observations: Four patients with NSF were treated with UV-A1 phototherapy at a tertiary medical center from 2005 through 2007. To our knowledge, it is unique to this series that all patients were receiving hemodialysis before, during, and after therapy with UV-A1. All experienced improvement in the degree of induration, and 2 experienced improvement in mobility of the hands and legs. Total treatments ranged from 22 treatments (with a cumulative dose of 1855 J/cm2) to 50 treatments (total UV-A1 exposure, 3850 J/cm2). No adverse events were observed. Conclusions: Although no patient had complete resolution of indurated plaques, the improvement was substantial. For 2 patients, it resulted in a resumption of hand and leg mobility. As a result, UV-A1 therapy may represent a treatment for NSF when kidney transplantation is not an option or is delayed. Limitations of this study include the lack of a controlled trial, lack of quantification of gadolinium levels within tissue, and the lack of a defined grading scale for NSF severity.
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U2 - 10.1001/archdermatol.2009.245
DO - 10.1001/archdermatol.2009.245
M3 - Article
C2 - 19841406
AN - SCOPUS:70350223981
SN - 0003-987X
VL - 145
SP - 1170
EP - 1174
JO - Archives of Dermatology
JF - Archives of Dermatology
IS - 10
ER -