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UVA Therapy in Vitiligo
Published in Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan, Comprehensive Textbook on Vitiligo, 2020
Surabhi Dayal, Priyadarshini Sahu
Pharmacology of Psoralens: Psoralens are derived from naturally occurring tricyclic furocoumarins. 8-MOP, (methoxsalen) is the most widely used derivative in PUVA; it is principally of plant origin but it is also available as a synthetic drug. 4,5,8-trimethyl psoralen (TMP; trioxsalen) is a synthetic drug and is primarily used for the treatment of vitiligo. It is less phototoxic after oral administration as compared to 8-MOP. 5-MOP (bergapten) which has a lower potential for phototoxicity, is also sometimes used.
Photochemotherapy
Published in Henry W. Lim, Nicholas A. Soter, Clinical Photomedicine, 2018
Psoralens belong to the furocoumarin group of compounds. The parent compound psoralen, and many of its derivatives, are widely distributed in plants and fruit such as limes, celery, figs, and lemons. Thus, psoralens are ingested in small quantities in a normal diet; the biological significance of this is unknown. Four psoralens are used for therapeutic purposes (Fig. 1). Methoxsalen, or 8-methoxypsoralen, which is obtained from the seeds of a plant called Ammi majus that grows in the Nile Valley, is the most commonly used psoralen. Trioxsalen, or 4, 5′-8-trimethylpsoralen, is a synthetic compound used for the treatment of vitiligo. Bergapten, or 5-methoxypsoralen, is available in Europe and is now undergoing trials in the United States to confirm its efficacy in psoriasis. Psoralen is used in some Mediterranean countries for the treatment of psoriasis and vitiligo.
Seborrheic dermatitis with massive facial hyperkeratosis resembling acquired ichthyosis
Published in Baylor University Medical Center Proceedings, 2020
Brett A. Austin, Alan Vu, William D. Boothe, Cloyce L. Stetson
SD has been associated with various medical conditions, including HIV/AIDS, malignancy, organ transplantation, chronic alcoholic pancreatitis, hepatitis C, as well as Parkinson’s disease, tardive dyskinesia, epilepsy, facial nerve palsy, and depression.2 Medications may also induce or flare a SD-like eruption, though the mechanism is unknown; implicated drugs include auranofin, aurothioglucose, buspirone, chlorpromazine, cimetidine, ethionamide, fluorouracil, gold, griseofulvin, haloperidol, interferon alfa, interleukin-2, lithium, methoxsalen, methyldopa, phenothiazines, psoralens, stanozolol, thiothixene, and trioxsalen.2,6 In immunosuppressed patients, SD presents more severely and is more refractory to treatment.4 Therefore, unusual presentations of SD should raise suspicion for an underlying medical condition, and a workup should be performed. Our patient’s recent weight loss was concerning for internal malignancy, but she declined further workup or age-appropriate screening and remained in her normal state of health other than an episode of telogen effluvium.