Atooppista ihottumaa voidaan hoitaa ennakoivasti

Atooppiseen ekseemaan liittyvät tulehdus ja kutina voivat viedä potilaan ja koko perheenkin yöunet. Iho-oireiden vaimentaminen onnistuu kerran tai kahdesti päivässä käytettävällä glukokortikoidivoiteella nopeasti iästä riippumatta. Hoitovaihtoehtoina ovat glukokortikoidien ohella kalsineuriinin estäjät. Säännöllistä ihon pesua ei saa unohtaa. Keskivaikean ja vaikean atooppisen ihottuman hoidossa lääkevoiteen levityskertoja harvennetaan vasta kutinan sammuttua. Uusiutumista ehkäisevää ylläpitohoitoakin voidaan harkita. Siinä lääkevoidetta käytetään noin kahtena päivänä viikossa entisille ihottuma-alueille vielä ihottuman kliinisesti rauhoituttuakin. Muina viikonpäivinä käytetään perusvoidetta. Ylläpitohoidolla ei näytä olevan enempää haittavaikutuksia kuin tavanomaisella reaktiivisella hoitotavalla. Kuitenkin ihottuman lehahdukset vähenevät merkitsevästi. Ylläpitohoidon seuranta-ajat ovat olleet alle vuoden pituisia. Ylläpitohoitoa voi suositella erityisesti keskivaikeaa tai vaikeaa atooppista ihottumaa sairastaville aikuisille, mutta erikoislääkärin valvonnassa se näyttäisi voivan sopia myös pienille lapsille

Long-term Outcome of Low-concentration Hexyl-5-aminolaevulinate Daylight Photodynamic Therapy for Treatment of Actinic Keratoses

Peer reviewe

Cutaneous Melanoma Patients Have Normal Repair Kinetics of Ultraviolet-Induced DNA Repair in Skin In Situ

The DNA lesions induced by ultraviolet radiation include cyclobutane pyrimidine dimers and 6–4 photoproducts. We investigated whether cutaneous melanoma patients have an impaired ability to repair their ultraviolet-induced photolesions. Seventeen patients with melanoma and 13 healthy controls took part in this study. Both groups received a dose of 40 mJ per cm2 Commission Internationale de l'Éclairage of solar simulating radiation on previously unexposed buttock skin. Skin biopsies were taken at 0 h, 24 h, and 48 h after ultraviolet exposure. A 32P-postlabeling method was used to measure both cyclobutane pyrimidine dimers and 6–4 photoproducts in skin. Cyclobutane pyrimidine dimers and 6–4 photoproduct levels did not differ in the melanoma patients from those in the control group at any time point post-ultraviolet radiation. The repair rate of cyclobutane dimer TT=C was faster than that for TT=T both at 24 h and 48 h postirradiation in both groups, providing evidence of site-specific repair (p < 0.05). We conclude that patients with melanoma have a normal ultraviolet-induced DNA repair capacity in skin in situ

Long-term Outcome of Daylight Photodynamic Therapy with Amino-5-laevulinate Nanoemulsion vs. Methyl-5-aminolaevulinate for Actinic Keratoses

Peer reviewe

Narrowband Ultraviolet B Exposures Maintain Vitamin D Levels During Winter : A Randomized Controlled Trial

Exposure to solar ultraviolet B radiation during the summer months is the main source of vitamin D (VD) for people living in northern latitudes. The aim of this study was to determine whether artificial narrowband ultraviolet B (NB-UVB) whole-body exposures could maintain VD levels in winter. The intervention group received 2 standard erythema doses (SEDs) of NB-UVB exposures every second week from October 2013 to April 2014. In October 2013 serum 25-hydroxyvitamin D concentrations were 78.3 nmol/l in the intervention group (n=16) and 76.8 nmol/l in the control group (n=18). By April 2014 the concentrations had increased by 11.7 nmol/l (p=0.029) in the intervention group and decreased by 11.1 nmol/l (p=0.022) in the control group. The baseline VD concentration showed a negative correlation (p=0.012) with body mass index (BMI). In conclusion, a suberythemal NB-UVB dose of 2 SED every second week maintains and even increases serum VD concentrations during the winter. A high BMI seems to predispose subjects to low levels of VD.Peer reviewe

Characteristics and Trends of Cutaneous Squamous Cell Carcinoma in a Patient Cohort in Finland 2006-2015

The incidence of cutaneous squamous cell carcinoma is increasing worldwide. In most epidemiological studies, only the first case of cutaneous squamous cell carcinoma is registered, underestimating the burden of the disease. To determine the frequency and detailed characteristics of cutaneous squamous cell carcinoma in a Finnish patient cohort, we performed a retrospective 10-year study taking into account multiple tumours in one patient. On the pathology database search and medical record review we identified 774 patients with a total of 1,131 cutaneous squamous cell carcinomas. The crude incidence increased from 18.6/100,000 persons in 2006 to 28.1 in 2015. The location of tumours differed between men and women: the greatest difference concerned cutaneous squamous cell carcinoma of the ear, with 93% of cases occurring in men. One fourth (24%) of patients had more than one tumour. A small shift from poorly to well-differentiated tumours was seen. In conclusion, the incidence of cutaneous squamous cell carcinoma increased, with many patients presenting with multiple tumours.Peer reviewe