Summary
Two male patients with longstanding contact sensitivity to chromium were treated with PUVA. One patient, suffering from concomitant photosensitivity, reacted very favorably; his skin lesions cleared and light tolerance increased. This was paralleled by a decrease in the photopatch test reactivity and by the extinction of the patch-test reactivity on PUVA-exposed (pigmented) skin. Patch and photopatch tests on PUVA-shielded skin showed no decrease in skin test reactivity. PUVA-treatment caused a decrease in the number of rosette-forming T cells and an increase in lymphocyte stimulation in both patients. In one patient, abnormally high PHA-induced suppressor cell activities were recorded prior to treatment; after PUVA therapy the values were back to normal. In both patients, the PPD-induced suppressor cell activity of PWM response was clearly increased by PUVA-therapy. Other suppressor cell functions were not much affected. It is concluded that while PUVA-therapy may produce some systemic immunological effects, its abating effect on contact sensitivity and photosensitivity is mainly mediated through local mechanisms in the skin.
Zusammenfassung
Zwei Patienten mit lang bestehender Kontaktempfindlichkeit auf Chrom wurden mit PUVA behandelt. Ein Patient, der gleichzeitig eine Photosensibilisierung aufweist, reagierte sehr günstig. Seine Haut besserte sich und die Lichttoleranz erhöhte sich. Dies war von einer Abnahme der Phototestreaktivität begleitet, die auf der PUVA-exponierten Haut (pigmentiert) graduiert werden konnte. Der Läppchentest und der Phototest auf der für PUVA geschützten Haut zeigte keine Verminderung der Hauttestreaktivität. PUVA-Behandlung verursachte eine Abnahme der Zahl der Rosettenbildenden T-Zellen und eine Intensivierung der Lymphocytenstimulation in beiden Patienten. Bei dem einen Patienten, der eine außergewöhnlich hohe PHA-induzierte Suppressor-Zellaktivität vor der Behandlung zeigte, wurden durch die Behandlung die Werte zur Norm zurückgebildet. Bei beiden Patienten wurde die PPD-induzierte Suppressor-Zellaktivität auf PWM deutlich durch PUVA-Therapie vermehrt. Andere Suppressor-Zellfunktionen waren nicht beeinträchtigt. Es wurde der Schluß gezogen, daß während der PUVA-Therapie wohl einige systemische immunologische Effekte auftreten können, der abschwächende Effekt auf die Kontaktsensibilisierung und Photosensibilisierung aber vornehmlich durch lokale Vorgänge in der Haut hervorgerufen werden.
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Jansén, C.T., Viander, M., Kalimo, K. et al. PUVA treatment in chromium hypersensitivity: Effect on skin reactivity and lymphocyte functions. Arch Dermatol Res 270, 255–261 (1981). https://doi.org/10.1007/BF00403929
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DOI: https://doi.org/10.1007/BF00403929