Endothelins and α‐melanocyte‐stimulating hormone are increased in plasma of patients treated with UVA1 and psoralen plus UVA

Abstract

Ultraviolet light (UV) and/or UVA plus psoralen (PUVA) may have a systemic effect on melanocytes of shielded skin. Melanocyte pro liferation and occurrence of UV- induced lentigines and malignan cies in sun- protected skin are in favor of this concept. 1– 4 Release of several melanocyte mitogens might be responsible for this ef -fect, but up- to- date results are inconsistent. In PUVA- treated re pigmenting generalized (non- segmental) vitiligo patients, a study has shown increased endothelin (ET)- 1 in plasma, whereas another study revealed normal ET- 1 but increased basic fibroblast growth factor (bFGF), stem cell factor (SCF) and hepatocyte growth factor (HGF) in sera. 5,6 In the present study, plasma ET- 1- 3, α - melanocyte-stimulating hormone ( α - MSH), bFGF, SCF, HGF, and granulocyte-macrophage colony- stimulating factor (GM- CSF) were assessed in the plasma of patients treated with UVA1 ( n = 16; disseminated morphea n = 4, eczema n = 6, lichen sclerosus et atrophicus n = 2, disseminated granuloma annulare n = 4), and cream PUVA ( n = 16; mycosis fungoides n = 3, prurigo simplex n = 3, atopic dermatitis n = 4, and non- segmental vitiligo n = 6). Selected patients were eligi ble for total body irradiation, were of similar age, day 1 but not at day 14 indicating that ET and α - MSH elevation is sustained and remains high so long as patients are under treat ment. Expectedly and due to the presence of the photosensitizer psoralen, PUVA therapy was significantly more effective in ET and α - MSH release in comparison with UVA1 at all post- irradiation eval uation time points.