Puva ve dar bant uvb fototerapilerinin derideki etkilerinin dermoskopla izlenmesi
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Dosyalar
Tarih
2009
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Dermatolojide artan sıklıkta kullanılmaya devam eden PUVA ve özellikle DB-UVB tedavilerinin dermoskopik olarak yan etkileri şimdiye kadar sadece nevüslerde incelenmiştir. Mevcut çalışmalarda ise derideki değişiklikler klinik, histolojik ve biyokimyasal olarak incelenmiştir. Bu nedenle UV ışınlarının derideki dermoskopik değişiklikleri yeterince bilinmemektedir.Çalışmamıza 30'u PUVA ve diğer 30'u da DB-UVB tedavisi alması uygun görülen ve en az 3 ay en fazla 8 ay düzenli olarak gelebilecek olanlar rastgele alındı. Bu çalışmada PUVA ve DB-UVB fototerapilerinin derideki vasküler, yapısal, papüler ve pigmentasyon değişikliklerini dermatoskopla değerlendirdik.Çalışmamızda tedaviye bağlı değişikliklerin tedavinin erken dönemlerinde başladığını ve zamanla klinik olarak belirginleşeceğini tesbit ettik. Her iki grupta da deltoidler ve skapulalar gibi güneş görmeyen alanlarda homojen blotch pigmentasyon , düzensiz blotch pigmentasyon, düzensiz granüler pigmentasyon, silik ağımsı pigmentasyon, belirgin ağımsı pigmentasyon ve lineer telenjiyektazi içeren yeni bölgelerin daha fazla oluşumu fototerapi sonucu ortaya çıktığını göstermektedir. Belirgin sulkuslar, silik sulkuslar ve romboid sulkuslar içeren yeni bölgeler PUVA grubunda deltoidler ve skapulalarda daha fazla görülmekte olup bunların oluşumunda fotokemoterapinin etkinliği rol oynamaktadır.Riski olan hastalar uzun vadede oluşacak fototerapi yan etkilerini önleyecek tedbirleri almak ve uygun tedavilerin düzenlenmesine katkıda bulunmak amacıyla dermoskopik olarak da değerlendirilmelidir. PUVA ve DB-UVB tedavilerinin kronik deri değişikliklerini ortaya koymak için daha uzun süreli ve daha geniş vaka serilerini içeren çalışmalara ihtiyaç vardır. Bu çalışmalar sonucunda fototerapinin neden olduğu değişiklikleri önleyebilecek yeni yöntemler bulunabilirse sık olarak bu tedavileri alma durumunda olan hastalar ve biz dermatologlar daha güvenli bir şekilde bu tedavileri uygulayabileceğiz.Sonuç olarak kronik değişiklikleri tesbit etmede şimdiye kadar kullanılan klinik, histolojik ve biyokimyasal incelemelere dermoskopi incelemesi de eklenerek daha ayrıntılı incelemeler yapılmalıdır. Bu çalışma bu konunun önemini ortaya koymak ve yeni çalışmalara ışık tutmak amacıyla yapılmıştır.
Until now, dermoscopic side effects of PUVA and especially narrow band-UBV therapy which are continued to be used with increasing frequency in dermatology have only been examined on nevus. In present studies, however, changes on skin have been examined in clinical, histological and biochemical point of view. Dermoscopic changes of UV rays on skin are thus not sufficiently known.For this study, a total of sixty patients who were able to continue their treatment for at least three months to a maximum of eight months period were randomly chosen such that thirty patients considered receiving PUVA therapy while other thirty patients decided to have narrow band-UVB therapy. In this study vascular, structural, papular and pigmentation changes on skin due to PUVA and DB-UVB phototherapy were examined by dermoscop.It was found in this study that changes related to the treatment had started in early stages of treatment and became clinically evident in the course of time. In both groups of patients, more formation of new areas including homogeneous bloch pigmentation, irregular bloch pigmentation, irregular granular pigmentation, indistinct network pigmentation, distinct network pigmentation and linear telengiectasia in areas not exposed to sunlight such as deltoids and scapulas made us think the that their appearance are as a result of phototherapy. New areas including distinct sulcus, indistinct sulcus and rhomboid sulcus are more frequently seen on deltoids and scapulas in PUVA group, while activity of photo chemotherapy played a role in their formation.Patients under risk should also be evaluated in the view of dermoscopy in order to take precautions to prevent side effects of phototherapy that will arise in long term and to contribute to the arrangement of appropriate treatments of such patients. It is therefore necessary to carry out studies for a longer period of time and with a wider range of case series in order to put forward chronic skin changes due to both PUVA and narrow band-UVB therapy. As a result of such studies, new methods can be developed to prevent those changes that phototherapy causes enabling both patients who frequently undergo such treatments and us, the dermatologists, carry out those treatments more safely.As a result, further detailed research must be carried out by including dermoscopic examination besides clinical, histological and biochemical examinations which are being used till now to determine chronic changes. This study is carried out to put forward the importance of the subject and to shed light on new studies in this area.
Until now, dermoscopic side effects of PUVA and especially narrow band-UBV therapy which are continued to be used with increasing frequency in dermatology have only been examined on nevus. In present studies, however, changes on skin have been examined in clinical, histological and biochemical point of view. Dermoscopic changes of UV rays on skin are thus not sufficiently known.For this study, a total of sixty patients who were able to continue their treatment for at least three months to a maximum of eight months period were randomly chosen such that thirty patients considered receiving PUVA therapy while other thirty patients decided to have narrow band-UVB therapy. In this study vascular, structural, papular and pigmentation changes on skin due to PUVA and DB-UVB phototherapy were examined by dermoscop.It was found in this study that changes related to the treatment had started in early stages of treatment and became clinically evident in the course of time. In both groups of patients, more formation of new areas including homogeneous bloch pigmentation, irregular bloch pigmentation, irregular granular pigmentation, indistinct network pigmentation, distinct network pigmentation and linear telengiectasia in areas not exposed to sunlight such as deltoids and scapulas made us think the that their appearance are as a result of phototherapy. New areas including distinct sulcus, indistinct sulcus and rhomboid sulcus are more frequently seen on deltoids and scapulas in PUVA group, while activity of photo chemotherapy played a role in their formation.Patients under risk should also be evaluated in the view of dermoscopy in order to take precautions to prevent side effects of phototherapy that will arise in long term and to contribute to the arrangement of appropriate treatments of such patients. It is therefore necessary to carry out studies for a longer period of time and with a wider range of case series in order to put forward chronic skin changes due to both PUVA and narrow band-UVB therapy. As a result of such studies, new methods can be developed to prevent those changes that phototherapy causes enabling both patients who frequently undergo such treatments and us, the dermatologists, carry out those treatments more safely.As a result, further detailed research must be carried out by including dermoscopic examination besides clinical, histological and biochemical examinations which are being used till now to determine chronic changes. This study is carried out to put forward the importance of the subject and to shed light on new studies in this area.
Açıklama
Anahtar Kelimeler
Fototerapi, Phototherapy, Dermatoloji, Dermatology
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Deniz, F. (2009). Puva ve dar bant uvb fototerapilerinin derideki etkilerinin dermoskopla izlenmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Deri ve Zührevi Hastalıklar Anabilim Dalı, Konya.
