Document Detail

Photoprotection by thalidomide in patients with chronic cutaneous and systemic lupus erythematosus: discordant effects on minimal erythema dose and sunburn cell formation.
MedLine Citation:
PMID:  15327555     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Thalidomide is an anti-inflammatory and immunomodulatory agent with proven efficacy in several refractory inflammatory skin conditions including photoexacerbated skin diseases. The effects of thalidomide on ultraviolet (UV)-induced cutaneous damage in humans have not been extensively studied. We describe the results of minimal erythema dose (MED) testing in nonlesional skin of three patients with chronic cutaneous lupus erythematosus (CCLE) before and after treatment with thalidomide. OBJECTIVES: To determine whether thalidomide treatment provides clinical and histological evidence of photoprotection from acute UV injury. METHODS: MED testing was performed in nonlesional skin of three patients with CCLE before and after treatment with thalidomide. Skin biopsy specimens were taken from MED sites for in situ immunochemistry. RESULTS: In each patient, the MED to UVB irradiation was significantly higher while the patient was receiving thalidomide treatment than in the absence of thalidomide, suggesting a systemic photoprotective effect. Thalidomide treatment had no significant effect on markers of apoptosis including sunburn cell formation and terminal deoxynucleotidyl transferase-mediated biotinylated deoxyuridine triphosphate nick end labelling, which identifies single-strand breaks in DNA. CONCLUSIONS: Thalidomide inhibits acute UVB erythema at 24 h after exposure, as a 100-mg daily dose of this drug for 4 weeks conveyed a sun protection factor of 1.56 to > 4.0. We conclude that inhibition of UVB-induced inflammation may, in part, explain the therapeutic benefits of this agent on photosensitive diseases.
D L Cummins; A A Gaspari
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The British journal of dermatology     Volume:  151     ISSN:  0007-0963     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-08-25     Completed Date:  2004-12-16     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  458-64     Citation Subset:  IM    
Johns Hopkins Medical Institution, Baltimore, MD, USA.
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MeSH Terms
Immunosuppressive Agents / therapeutic use*
In Situ Nick-End Labeling
Lupus Erythematosus, Discoid / drug therapy*,  pathology
Lupus Erythematosus, Systemic / drug therapy*,  pathology
Middle Aged
Radiation Dosage
Radiation-Protective Agents / therapeutic use*
Skin / drug effects,  pathology,  radiation effects
Sunburn / etiology,  pathology
Thalidomide / therapeutic use*
Ultraviolet Rays
Grant Support
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Radiation-Protective Agents; 50-35-1/Thalidomide

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