Skip to main content
SpringerLink
Log in

Phototherapy of urticaria pigmentosa: Clinical response and changes of cutaneous reactivity, histamine and chemotactic leukotrienes

  • Original Contributions
  • Published:
Archives of Dermatological Research Aims and scope Submit manuscript

Summary

Ten patients with moderate to very severe urticaria pigmentosa were studied for the therapeutic effect of photochemotherapy (PUVA; six adults) and selective ultraviolet phototherapy (SUP; four adolescents). Despite a high mean PUVA dosage (138.6 ±63.4 J/cm2), only two patients had a very good response, while three had a good response and one had a fair response. On the reduction of the frequency of treatments, the symptoms gradually recurred, and several months after the discontinuation of therapy, the clinical status had reached the level prior to PUVA. The results with SUP were even less encouraging. A number of biophysical and biochemical parameters of the skin were studied in five patients before PUVA treatment, immediately after several months of PUVA treatment and again 5 months after the discontinuation of PUVA treatment. Weal and erythema reactions to intracutaneous skin tests remained unchanged after PUVA, while wealing with topically applied dimethylsulfoxide (DMSO) decreased. Transepidermal water loss was markedly reduced over DMSO weals. Histamine levels, which were elevated in lesional but not in normal skin, dropped with PUVA treatment, but after the discontinuation of treatment, they increased again in the lesions. On reverse-phase high-performance liquid chromatography, two main chemotactic factors, leukotriene B4 and 5-HETE, were identified in lesional skin. Chemotactic activity was elevated in both lesional and uninvolved patient skin, reached normal levels at both sites after PUVA and maintained these low levels for several months after the discontinuation of treatment. Our data suggest that PUVA has reversible anti-inflammatory effects on human skin, because it increases epidermal-barrier function and decreases the synthesis of mediators of inflammation. These observations show the transitory therapeutic benefit of PUVA in patients with urticaria pigmentosa.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Becker SW (1959) Histologic changes in human skin following psoralen therapy. J Invest Dermatol 32:263–267

    Google Scholar 

  2. Borgeat P, Samuelsson B (1979) Transformation of arachidonic acid by rabbit polymorphonuclear leukocytes. Formation of a novel dihydroxyeicosatetraenoic acid. J Biol Chem 254:2643–2646

    Google Scholar 

  3. Christophers E, Hönigsmann H, Wolff K, Langner A (1978) PUVA treatment of urticaria pigmentosa. Br J Dermatol 98:701–702

    Google Scholar 

  4. Combs JW, Lagunoff D, Benditt EP (1965) Differentation and proliferation of embryonic mast cells of the rat. J Cell Biol 25:577–592

    Google Scholar 

  5. Czarnetzki BM (1983) A double-blind cross-over study of the effect of ketotifen in urticaria pigmentosa. Dermatologica 166:44–47

    Google Scholar 

  6. Czarnetzki BM, Behrendt H (1981) Urticaria pigmentosa: clinical picture and response to oral disodium cromoglycate. Br J Dermatol 105:563–568

    Google Scholar 

  7. Czarnetzki BM, Grabbe J (1983) Biological and chemical characterization of cosinophil chemotactic factors from human leukocytes. Agents Actions [Suppl] 12:204–216

    Google Scholar 

  8. Czarnetzki BM, König W, Lichtenstein LM (1976) Eosinophil chemotactic factor (ECF). I. Release from polymorphonuclear leukocytes by the calcium ionophore A 23187. J Immunol 117:229–234

    Google Scholar 

  9. Czarnetzki BM, Grabbe J, Rosenbach T, Mardin M (1984) Identification of chemotactic lipoxygenase products in psoriatic skin. J Invest Dermatol 82:477–479

    Google Scholar 

  10. Doig MV, Ford-Hutchinson AW (1980) The production and characterization of products of the lipoxygenase system released by rat peritoneal macrophages. Prostaglandins 20:1007–1019

    Google Scholar 

  11. Embery G, Dougard PH (1971) The isolation of dimethylsulfoxide-soluble components from human epidermal preparations: a possible mechanism of action of dimethylsulfoxide in effecting percutaneous migration phenomena. J Invest Dermatol 57:308–311

    Google Scholar 

  12. Fjellner B, Hägermark O (1982) Histamine release from rat peritoneal mast cells exposed to ultraviolet light. Acta Derm Venereol (Stockh) 62:215–220

    Google Scholar 

  13. Frosch PJ (1981) Methoden zur Charakterisierung der Hautempfindlichkeit-Ammoniak-MBZ und DMSO-Test. Hautarzt 32 (supp 5):449–451

    Google Scholar 

  14. Frosch PJ, Duncan S, Kligman AM (1980) Cutaneous biometrics. I. The response of human skin to dimethylsulphoxide. Br J Dermatol 102:263–274

    Google Scholar 

  15. Goetzl EJ (1981) Selective feed-back inhibition of the 5-lipoxygenation of arachidonic acid in human T-lymphocytes. Biochem Biophys Res Commun 101:344–350

    Google Scholar 

  16. Grabbe J, Czarnetzki BM, Mardin M (1984) Release of lipoxygenase products of arachidonic acid from isolated human keratinocytes. Arch Dermatol Res 276:128–130

    Google Scholar 

  17. Granerus G, Roupe G, Swanbeck G (1981) Decreased urinary histamine metabolite after successful PUVA treatment of urticaria pigmentosa. J Invest Dermatol 76:1–3

    Google Scholar 

  18. Johnson GJ, Silvis SE, Roitman B, Blumenthal M, Gilbert HS (1980) Long-term treatment of systemic mastocytosis with histamine H2 receptor antagonists. Am J Gastroenterol 74:485–489

    Google Scholar 

  19. Kligman AM (1965) Topical pharmacology and toxicology of dimethyl sulfoxide. Part I. J Am Mol Assoc 193:796–801

    Google Scholar 

  20. Lafferty KJ, Woolnough J (1977) The origin and mechanism of the allograft reaction. Immunol Rev 35:231–262

    Google Scholar 

  21. Parker CW (1982) The chemical nature of slow-reacting substances. In: Weissmann G (ed) Advances in inflammation research, vol 4. Raven Press, New York, pp 1–24

    Google Scholar 

  22. Sauder DN, Frances P, Defabo EC, Defabo EC, Katz SI (1983) Ultraviolet radiation inhibits alloantigen presentation by epidermal cells: partial reversal by the soluble epidermal cell product, epidermal cell-derived thymocyte-activating factor (ETAF). J Invest Dermatol 80:485–489

    Google Scholar 

  23. Shore GA, Burkhalter A, Cohn VA (1959) A method for the fluorometric assay of histamine in tissues. J Pharmacol Exp Ther 127:182–186

    Google Scholar 

  24. Soter NA, Austen F, Wassermann SI (1979) Oral disodium cromoglycate in the treatment of systemic mastocytosis. N Engl J Med 301:465–469

    Google Scholar 

  25. Stüttgen G, Brinkmann-Raestrup I, Haller L, Knetsch V, Schalla W (1979) Melanin granula distribution and phagocytosis in psoriasis vulgaris after PUVA therapy. Arch Dermatol Res 264:29–35

    Google Scholar 

  26. Väätäinen N, Hannuksela M, Karvonen J (1981) Trioxsalen baths plus UV-A in the treatment of lichen planus and urticaria pigmentosa. Clin Exp Dermatol 6:133–138

    Google Scholar 

  27. Vella Briffa D, Eady RAJ, James MP, Gatti S, Bleehen SS (1983) Photochemotherapy (PUVA) in the treatment of urticaria pigmentosa. Br J Dermatol 109:67–75

    Google Scholar 

  28. Wolff K, Hönigsmann H, Gschnait F, Konrad E (1974) Photochemotherapie bei Psoriasis: Klinische Erfahrungen bei 152 Patienten. Dtsch Med Wochenschr 100:2471–2477

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Dermatology, Westfälische Wilhelms-Universität, Von-Esmarch-Str. 56, D-4400, Münster, Federal Republic of Germany

    B. M. Czarnetzki, T. Rosenbach, G. Kolde & P. J. Frosch

Authors
  1. B. M. Czarnetzki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Rosenbach
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Kolde
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. J. Frosch
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Czarnetzki, B.M., Rosenbach, T., Kolde, G. et al. Phototherapy of urticaria pigmentosa: Clinical response and changes of cutaneous reactivity, histamine and chemotactic leukotrienes. Arch Dermatol Res 277, 105–113 (1985). https://doi.org/10.1007/BF00414106

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00414106

Key words

Search

Navigation