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Introduction: UVA therapy is used in treatment of wide range of skin diseases, which proceed with hardening of the skin or inflammation. First use of ultraviolet radiation can be tracked down to 1896. Wavelength vary among diseases against which it is used. In literature as results of therapy are mentioned improvement of skin elasticity, reduction of inflammation, and protection from relapse. In terms of sclerotic skin diseases most promising effect is seen in reducing skin hardness in the mechanism of stimulating collagen breakdown. The therapy itself has a good safety profile, but is time-consuming due to the high frequency of irradiation. Effectiveness of treatment are determined by factors such as advancement of skin lesions, pigmentation and the intensity of the therapy itself. Aim of study: The aim of the study is to summarize the available knowledge about the UVA therapy in skin diseases. The way of work, effectiveness of treatment, side effects and potential new methods of use were summarized and described. Materials and methods: The literature available in PubMed database was reviewed using following keywords: “UVA therapy”, “UVA”, “Scleroderma”, “Buschke’s Scleredema”, “Systemic sclerosis”, “Morphea” Conclusion: UVA1 therapy is one of the most effective therapeutic options in subtypes of morphea which affect only superficial tissues. Phototherapy accelerate healing of ulcerations on fingertips in patients with Systemic sclerosis. Patient suffering from Buschke Sclerederma had good response to therapy. Observed side effects consist of hyperpigmentation, erythema, xerosis and pruritus in range from mild to severe. Carcinogenic effect has not yet been proven.

Introduction: Localised scleroderma (sclerodermia circumscripta, morphea) is a type of scleroderma limited to the skin. Phototherapy with UVA radiation is an alternative method of treatment of localized scleroderma. UVA radiation inhibits or stops the fibrotic processes, what leeds to softening of skin changes particularly in morphea. Patients and methods: 18 patients (16 females and 2 males) hospitalized in the Dermatological Department in Katowice or at the Outpatients Dermatological Department in Katowice were included into this study. The age of the patients was from 19 to 63 years (mean 45.5±15.2 years). PUVA (psoralen and UVA radiation) sessions were performed in the patients 3 times a week (every second day) from the beginning dose of radiation 4-5±0.48 J/cm2. Results: Clinical improvement was observed in 81.3% of the patients (included 43,7% who estimated their own improvement as good). 27% bigger improvement was stated by the questionnaired patients treated with PUVA-therapy in comparison with questionnaired doctors. Conclusions: On the base of the study PUVA-therapy can be considered as an alternative, effective method of treatment of localized scleroderma. [ABSTRACT FROM AUTHOR]

Localised scleroderma (sclerodermia circumscripta, morphea) is a type of scleroderma limited to the skin. Phototherapy with UVA irradiation is an alternative method of treatment of localized scleroderma. UVA irradiation has a mechanism of action which inhibits or stops the fibrotic processes, what leeds to softening of skin changes particularly in morphea. The kind and pattern of phototherapy should be adjusted to the skin type and the intensity of illness. [ABSTRACT FROM AUTHOR]

Vitiligo is an idiopathic chronic skin disease that is notable for depigmented macules forming by destruction of melanocytes mediated by cells of the immune system. Vitiligo occurs in 1-2% of the population irrespective of race and without predilection to gender or age. The dynamics and extent of the disease vary widely, ranging from stable cases with isolated minor foci to states showing rapid progression and occupying large areas of the skin. For many patients, the disease represents a serious cosmetic defect which limits their activities in various spheres of life. There are many noninvasive methods of treatment but none of them offers a guarantee of complete therapeutic success. PUVA- and UVB-therapy are recognized as the most effective and most commonly used methods. The management of vitiligo should also include education, cosmetic correction options, and psychotherapy in some cases.

Skin scleroderma (LS) is characterised by stiffness of skin and/or deeper tissues. As opposed to systemic scleroderma, the involvement of internal organs and Raynaud phenomenon are predominately not observed in morphea. LS is quite rare disease, more frequent in women and young people. There are several useful classifications of skin scleroderma in literature, however the classification which concerns the shape and extension of LS lesion and depth of stiffness is concerned to be the most clear. LS is divided into: plaque morphoea, generalised morphoea, blistering morphoea, linear morphoea and deep morphoea. Different types of skin scleroderma lesions can be observed in one patient or can combine linear and deep fibrosis. Presented classification is clinically useful and it has prognostic and therapeutic implications.

Phototherapy is nowadays one of the main methods used in dermatology. It can be used alone or in combination with oral and/or topical treatment. The action of ultraviolet radiation is exploited for the treatment of many diseases. This paper presents the application of various phototherapy methods, their side-effects and ways of preventing them.

Scleroderma is the autoimmunologic disease with induration and fibrosis of the skin, subcutaneous tissue; sometimes refers to muscles, bones and other internal organs. Pathogenesis of morphea is still unknown. There are two main types of scleroderma: the first type is related only to the skin (localized scleroderma--morphea), while the second is connected with fibrosis and induration of the skin, lungs, heart and other organs (systemic sclerosis). There are various clinical forms of scleroderma circumscripta: linear scleroderma (the most frequent in children), morphea en plaque, generalized morphea, nodular and keloidea like, morphea guttata, scleroderma circumscripta with blisters on the surface-bullous morphea. Morphea profunda is the most severe type of scleroderma localized on the skin. Although the diagnosis of morphea is not so difficult, the treatment is problematic and not very effective. It is very important to initiate the proper treatment as soon as possible. There are three main ways of morphea treatment: medication (receiving local or per os), physical methods (for example phototherapy) and balneotherapy or climatic treatment.

Tigason was applied in 51 patients with psoriasis and 19 with other skin diseases. In 18 patients was applied alone, in 42 combined with PUVA and in 10 with SUP. Roaccutan was applied in 18 patients with acne conglobata et phlegmonous resistant to other methods of treatment. Tigason was found to be a useful drug in psoriasis and some other skin diseases. The combination with PUVA or SUP allowed to reduce the doses of drugs and the dose of radiation. Roaccutan was found to be a useful drug in severe forms of acne vulgaris. The side effects of the treatment with retinoids were transient and they did not create danger to the patients.

In 10 patients with generalized psoriasis treated by this method biochemical and histological examinations of liver biopsy specimens were done before and after 60 days of the treatment. In some cases a transient rise of A1AT activity, raised activity of alkaline phosphatase and gamma-glutamyltranspeptidase were noted. Histological examinations demonstrated slight hepatocellular damage with microfocal necrosis, fatty infiltration of some cells and increase in the structural elements of cytoplasm.

PUVA treatment was applied in 16 patients with chronic urticaria (7 with solar urticaria, 2 with cold urticaria and 7 with urticaria of unknown etiology), 26 with chronic disseminated eczema and 41 with atopic dermatitis. In all 9 patients with physical urticaria, a clear-cut improvement was observed. The results from the treatment of chronic urticaria of unknown etiology were considerably poorer (improvement in 2 out of 7 cases). In patients with chronic disseminated eczema, a full remission was present in 5 and considerable improvement in 20 cases. In group of 41 patients with atopic dermatitis, 52 cures were carried out; in 8 patients the cure was repeated 2-3 times at 1,0-0,5-year intervals. Complete recovery was achieved in 34 and significant improvement in 16 out of them. The results presented seem to indicate the effectiveness of PUVA treatment to some allergic skin diseases, the more so that the number of exposures required to obtain a considerable improvement, or even full remission, is comparatively low (3-21 occasions), which reduces the risk of complications.

The determinations of the activity of lysozyme in the serum, lysosomes and lysosomal supernatant of neutrophil granulocytes were done in 33 patients with generalized psoriasis and in 19 healthy controls. A decrease of lysozyme activity was demonstrated in the serum, lysosomes and lysosomal supernatant in the patients. During treatment by the PUVA method this activity rose gradually above the values in the control group. Systematic determination of lysozyme activity may help in monitoring of treatment progress.