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Geriatric hair and scalp disorders
Published in Robert A. Norman, Geriatric Dermatology, 2020
Consistent adherence to a treatment regimen is necessary to control scalp psoriasis105. As in seborrheic dermatitis, treatment consists of removal of the scale and medicating the underlying skin. Some older individuals can manage scalp psoriasis independently. Others need help with the application of medication and shampooing. The presence of hair complicates treatment. Removal of scale is the first step. Hydration of the scalp by shampooing, soaking the scalp, or wrapping with hot towels will help to improve the effectiveness of medications. Several means may be helpful in loosening the scales. Oils (vegetable oils) with or without a corticosteroid may be left on overnight with occlusion and shampooed out the following morning using a rotation of medicated shampoos (discussed in the previous section). One such oil and corticosteroid product contains peanut oil and fluocinolone 0.01%, another contains phenol and saline. Keratolytic and antimitotic agents such as oils containing tars aid in loosening the adherent scales. After daily shampooing, corticosteroids in the form of sprays and short-term high-potency106, 107 or long-term mid-strength topical solutions can safely be used without scalp atrophy108. A series of Grenz ray treatments may be helpful in the acute phase109. A Grenz ray is a soft X-ray, intermediate between ultraviolet light and conventional X-rays, capable of by-passing hair to penetrate the scalp to a depth of approximately 4 mm. Application of UV light with a special combing device may be useful and suitable for home use110.
Hand Dermatitis
Published in Donald Rudikoff, Steven R. Cohen, Noah Scheinfeld, Atopic Dermatitis and Eczematous Disorders, 2014
Nina C. Botto, Erin M. Warshaw
Grenz rays (ultrasoft radiographs or Bucky rays) have also been used to treat focal areas of dermatitis such as on the hands. Almost all of the radiation emitted is absorbed completely in the upper 3 mm of the skin, rendering Grenz rays the least penetrating form of ionizing radiation used by dermatologists (Edwards and Edwards 1990). The effectiveness of Grenz ray therapy is thought to involve reduction of the number of Langerhans cells within the epidermis (Cipollaro 1991). The therapeutic dosages used in Grenz ray therapy (150–300 rad) are not known to produce adverse effects such as erythema, exudation, and ulceration. Walling et al. (2008) reported the use of Grenz ray treatment at a weekly dose of 400 rad (4 Gy) in a dermatological surgeon with recalcitrant frictional hyperkeratotic hand dermatitis. He had marked improvement after 3-weekly treatments and has remained clear for 4 years following a total course of six Grenz ray sessions.
Review: the reemergence of brachytherapy as treatment for non-melanoma skin cancer
Published in Journal of Dermatological Treatment, 2018
Koji Ota, Tony Adar, Laura Dover, Amor Khachemoune
Radiotherapy for NMSC can be broadly divided into external beam radiation therapy (EBRT) and brachytherapy. EBRT typically involves the use of photons or electrons generated from a linear accelerator. Types of EBRT are further divided based on power emitted and radiation source to target surface distance (Table 1). Grenz Rays, or ultrasoft therapy was widely used by dermatologists since its development in the 1920’s, but due to its low energy output of 8–20 kV it is not sufficient for NMSC and is rarely used today (5). On the other hand, brachytherapy (from the word “brachy,” or close distance), involves placing a gamma-emitting radioactive isotope adjacent to the target lesion.
Radiation therapy techniques in the treatment of skin cancer: an overview of the current status and outlook
Published in Journal of Dermatological Treatment, 2019
Ali Pashazadeh, Axel Boese, Michael Friebe
Grenz ray is produced by an X-ray tube that is operating in the range of 10–30 kV. Its half value depth in tissue is 0.5 mm and significant part of it is absorbed within the 2 mm of skin tissue (24). It was traditionally used in dermatology for irradiation of very thin lesions of the skin such as Bowen’s disease (25). While getting out of dermatology practices, it has still applications in some clinics, particularly in Germany.
Pharmacotherapeutic approaches for treating psoriasis in difficult-to-treat areas
Published in Expert Opinion on Pharmacotherapy, 2018
Dario Kivelevitch, Jillian Frieder, Ian Watson, So Yeon Paek, M. Alan Menter
Phototherapy, photochemotherapy, and other forms of radiation therapy have shown beneficial outcomes. One retrospective study reported significant improvements in proximal nail fold dystrophy and nail plate crumbling, but not nail pitting, with Psoralen and UVA (PUVA) therapy [89]. Grenz rays and electron beams showed variable efficacy. Further clinical data is required to determine the role of radiation therapy in nail psoriasis.