Decreased risk of major osteoporotic fracture following long-term narrowband UVB phototherapy in patients with vitiligo: An 11-year nationwide propensity score-matched study

( Tae Young Han ),( Jae Eun Choi ),( June Hyun Kyung Lee ),( Young Shin Kim ),( Kyungil Kim ),( Jung Min Bae ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1

Background: Narrowband ultraviolet B (NB-UVB) phototherapy is widely used for the treatment of vitiligo and chronic inflammatory skin disorders. In addition to its therapeutic effects in skin disorders, NB-UVB phototherapy has been shown to increase the serum vitamin D concentration. Objectives: This study investigated the incidence of major osteoporotic fractures in patients with vitiligo after NB-UVB phototherapy. Methods: A nationwide population-based retrospective cohort study was conducted using the Korean National Health Insurance claims database (2007-2017). The study included patients who had undergone ≥ 100 phototherapy sessions (Phototherapy group) or < 3 phototherapy sessions (No phototherapy group). Using 1:2 propensity score matching, the groups were matched for age, sex, and insurance type, and for comorbidities. Results: The overall risk of osteoporotic fracture was significantly lower in the Phototherapy group compared to the No phototherapy group (hazard ratio [HR] = 0.745, 95% confidence interval [CI] = 0.602-0.921). In subgroup analyses, the risk was significantly lower in the female and older age groups. Conclusion: The risk of major osteoporotic fractures was lower in patients with vitiligo treated with long-term NB-UVB phototherapy.

Vitamin D and narrowband ultraviolet B phototherapy for chronic kidney disease-associated pruritus

( Youn Kyung Kee ),( Hee Jung Jeon ),( Jieun Oh ),( Dong Ho Shin ) 대한신장학회 2024 Kidney Research and Clinical Practice Vol.43 No.2

Background: In addition to improving the serum vitamin D balance, narrowband ultraviolet B (NB-UVB) phototherapy can effectively treat chronic kidney disease-associated pruritus (CKD-aP). We investigated the degree of CKD-aP amelioration according to changes in the serum vitamin D level after NB-UVB phototherapy. Methods: This was a before-after clinical study in patients with refractory CKD-aP on hemodialysis. NB-UVB phototherapy was administered thrice weekly for 12 weeks. The response of CKD-aP to NB-UVB phototherapy was assessed as the change in pruritus intensity over time. A rapid response was defined as a reduction in the visual analog scale (VAS) score of ≥50% within the first 6 weeks of NB-UVB phototherapy. Results: We included 34 patients in this study. Although serum 25-hydroxy vitamin D [25(OH)D] concentrations increased significantly, by a median of 17.4 ng/mL, after the phototherapy course, other serologic parameters did not change. NB-UVB phototherapy reduced the VAS score for pruritus intensity over time significantly more in patients with Δ25(OH)D of >17.4 ng/mL than in patients with Δ25(OH)D of ≤17.4 ng/mL (p = 0.001). Ten patients were rapid responders. Multivariate logistic regression analysis showed that Δ25(OH)D was independently associated with rapid response (odds ratio, 1.29; 95% confidence interval, 1.02-1.63; p = 0.04). Conclusion: The effect of NB-UVB phototherapy on patients with CKD-aP correlated with their increase in serum vitamin D levels. Further well-designed clinical and experimental studies are needed to clarify the relationship between NB-UVB phototherapy and serum vitamin D levels in patients with CKD-aP.

Protective effect of long-term NB-UVB phototherapy against cardiovascular and cerebrovascular events in patients with vitiligo: A 10-year population-based retrospective cohort study retrospective cohort study

( Jung Min Bae ),( Yoon Seob Kim ),( Eun Ho Choo ),( Mi-yeon Kim ),( Jun Young Lee ),( Hyung-ok Kim ),( Young Min Park ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Narrowband ultraviolet B (NB-UVB) phototherapy has been the mainstay of treatment for vitiligo, and many of patients with vitiligo receive NB-UVB phototherapy for a long period. However, the systemic effects of the long-term NB-UVB phototherapy on cardiovascular system have yet to be studied. Objectives: To investigate the impact of NB-UVB phototherapy on the risk of cardiovascular and cerebrovascular events in patients with vitiligo. Methods: A nationwide population-based retrospective cohort study was performed utilizing the Korean National Health Insurance Claims Database from 2007 to 2016. All patients with vitiligo aged ≥ 40 years were identified and categorized into four groups based on the sessions of NB-UVB phototherapy. Outcomes of interests were cardiovascular events and cerebrovascular events. Results: A total of 41,670 patients with vitiligo were enrolled. The risk of cardiovascular or cerebrovascular events was significantly decreased in patients who underwent ≥100 phototherapy sessions (n=2,759) compared with those who received no phototherapy (0-2 sessions; n=20,484) after adjustment for potential confounders (hazard ratio 0.807, 95% confidence interval 0.677-0.962). Conclusion: These findings suggest long-term NB-UVB phototherapy can lower the risks of cardiovascular and cerebrovascular events in patients with vitiligo.

Treatment response of vitiligo to phototherapy: a systematic review and meta-analysis of prospectivestudies

( Jung Min Bae ),( Han Mi Jung ),( Hyuck Sun Kwon ),( Ji Hae Lee ),( Gyong Moon Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

Background: Phototherapy has been the mainstay for management of vitiligo. Objectives: To estimate the treatment responses of vitiligo to phototherapy based on all relevant articles. Methods: Database search of MEDLINE, EMBASE and the Cochrane library from inception to January 26, 2016. All prospective studies reporting phototherapy outcome for ≥10 participants with generalized vitiligo were included. Of 319 studies initially identified, 35 were finally included in the analysis; 29 studies involving 1201 patients were included in the narrow-band ultraviolet B (NBUVB) group and 9 with 227 patients in the psoralen plus ultraviolet A (PUVA) group. Single-arm meta-analyses were performed for the NBUVB and PUVA groups, respectively. Results: Repigmentation rate was classified as at least mild (>25%), at least moderate (>50%), and marked (>75%) responses. For NBUVB phototherapy, an at least mild response occurred in 62.10% at 3 months, 74.17% at 6 months, and 75.03% at 12 months, and a marked response was achieved in 12.99% at 3 months, 19.17% at 6 months, and 35.68% at 12 months. For PUVA phototherapy, an at least mild response occurred in 51.38% at 6 months and 61.64% at 12 months. Marked responses were achieved in 44.21% on face/neck, 26.12% on trunk, 17.33% on extremities, and none on hands/feet after ≥6 months of NBUVB phototherapy. Conclusion: Long-duration phototherapy should be encouraged to enhance the treatment response. The greatest response is anticipated on the face/neck.

임신 기간 35주 미만인 미숙아에서 광선 치료 횟수에 미치는 인자와 임상적 특징

최소윤,정유진,황호연,홍유라 고신대학교(의대) 고신대학교 의과대학 학술지 2012 고신대학교 의과대학 학술지 Vol.27 No.2

Objectives: Clinical features according to the frequency of phototherapy and clinical risk factors on the number of phototherapy were investigated in premature births with gestation <35 weeks and birth weight ≤2,500 g. Methods: The 186 infants with gestation <35 weeks and birth weight ≤2,500 g were admitted to the neonatal intensive care unit of Kosin University Gospel Hospital from March 2009 to August 2010. The 171 infants were alive and had jaundice requiring phototherapy. Phototherapy was usually started to 50-70% of the maximal bilirubin level. They were divided into two groups according to the frequency of phototherapy as single phototherapy group (group I) and multiple phototherapy group (group II). We retrospectively reviewed the medical records of all patients. Results: The mean gestational age and birth weight of group I were 31.0±2.9 weeks and 1,596±485 g and those of group II were 31.1±2.6 weeks and 1,592±430 g. Compared with group I, albumin and Apgar score at 1 minute of group II were significantly higher and the day of peak bilirubin was also late. Duration of phototherapy in group II was statistically longer than that groupⅠ but duration of ventilator and aminophylline use for apnea was significantly shorter. The frequency of antibiotic use, incidence of bronchopulmonary dysplasia (BPD), and intraventricular hemorrhage (IVH) of group II were significantly lower than those of group I. Conclusions: The day of peak bilirubin was late and the frequency of antibiotic use, incidence of BPD, and IVH were low in group II. The aggressive phototherapy may be considered in premature births with jaundice.

신생아 황달에서 디옥타헤드랄 스멕타이트와 광선요법의 병행 치료시 효과

김희모,정영철,조동영,오명호 건국대학교 의과학연구소 2002 건국의과학학술지 Vol.12 No.-

Background : Dioctahedral smectite is an alumina silicate of phyllitic structure and absorbs bile acid in the intestine, forming a nonabsorbable complex preventing enterohepatic circulation. The purpose of this study is to clarify the value of dioctahedral smectite and the adequate dosage, in combination with phototherapy, as well as to confirm whether it shorten the duration of hospitalization, Method : Total 45 full-term neonate with a total bilirubin level greater than 12 ㎎/dl were studied. The neonate were randomly divided in to three groups :(1) Only phototherapy group(A)(2) 1.5g/day dioctahedral smectite with phototherapy group(B)(3) 3g/day dioctahedral smectite with phototherapy group(C). Results : Forty-eight hours and 72 hours after the beginning of the study, the mean bilirubin level among the B, C groups were significantly diminished than that of A group(P<0.05). The duration of phototherapy and hospitalization were significantly diminished in the C group. After phototherapy finished, mean bilirubin level was not significantly diminished. Conclusion : The data revealed that oral administration of dioctahedral smectite(especially 3 g/day with phototherapy group : C) not only increased the efficacy of phototherapy, but also shortened the duration of phototherapy.

Phototherapy-induced multiple actinic keratoses in a Korean psoriatic patient

( Ho June Lee ),( Sook Jung Yun ),( Jee Bum Lee ),( Seong Jin Kim ),( Young Ho Won ),( Seung Chul Lee ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Phototherapy is widely known as an effective treatment in generalized plaque of psoriasis. Acute complications of phototherapy manifested as redness, blisters and others, but chronic complications, including skin aging and skin cancer, are more seriously considered in psoriatic patients, who have been treated with long-term phototherapy. We report a 73-year-old male patient presenting with multiple pruritic brownish hyperkeratotic plaques on the neck, trunk and both extremities for 5 months. He was diagnosed with plaque psoriasis, and had been treated with phototherapy (PUVA+NBUVB) for approximately 25 years. He was on medication for hypertension and diabetes mellitus, but had no history of herbal medications for psoriasis. His Fitzpatrick skin type was 4. On physical examination, there were no specific findings except skin lesions. Skin biopsy was performed with the brownish crusted plaques, and was diagnosed as multiple actinic keratoses (AK). The AK lesions were completely removed by surgical excision. Considering that multiple AK developed only on the non-sunlight-exposed areas of trunk, we predict that extremely long-term phototherapy has a high potential to induce nonmelanoma skin cancer (NMSC) in Korean

Ten-year experience of phototherapy in Yonsei Medical Center

Park, Sang Hoon,Hann, Seung-Kyung,Park, Yoon-Kee Yonsei University, College of Medicine 1996 Yonsei medical journal Vol.37 No.6

Sociodemographic and Clinical Characteristics of Geriatric Patients with Psoriasis Receiving Narrowband Ultraviolet B Phototherapy

Lili Legiawati,Rinadewi Astriningrum,Shannaz Nadia Yusharyahya,Vivianne Chandrakesuma 대한노인병학회 2020 Annals of geriatric medicine and research Vol.24 No.4

Background: Although the demographic and clinical characteristics of patients with psoriasis have been evaluated in many countries, studies specifically on geriatric patients remain scarce and none have focused on those receiving phototherapy. This study describes the sociodemographic and clinical characteristics of geriatric patients with psoriasis in Indonesia, specifically those who received narrowband ultraviolet B (NB-UVB) phototherapy. Methods: This retrospective study using data obtained from phototherapy and medical records of psoriasis patients who received phototherapy in 2014–2019 was conducted at the Dermatovenereology Clinic of Dr. Cipto Mangunkusumo National General Hospital. Results: Among 24 geriatric patients with psoriasis who received NB-UVB phototherapy, the median age of onset was 61 years (range, 36–74 years). Regarding comorbidities, 15 patients (62.5%) had dyslipidemia, 15 patients (62.5%) had hypertension, 11 patients (45.8%) had obesity, 9 patients (37.5%) had periodontitis/gingivitis, 9 patients (37.5%) had type 2 diabetes mellitus, and 6 patients (25.0%) had hyperuricemia. Conclusion: Some comorbidities have been associated with psoriasis, including metabolic syndrome and periodontitis. The data from this study could help physicians in evaluating and making appropriate clinical decisions when managing psoriasis patients in the geriatric population.

자아 커뮤니케이션과 사진치료기법에 관한 고찰-사진치료과정에서의 커뮤니케이션을 중심으로-

이지양 한국일러스아트학회 2013 조형미디어학 Vol.16 No.4

In our society, there are a variety of types of communication. In addition, depending on the nature of that type in the same way we sometimes communicates in different ways, sometimes. And the way this communication in current society, our way of life can be called. However, the new media environment in a variety of formats in the way of life by intervening if a relatively large surface conditions is limited. Such as interpersonal communication or group communication and facilitate problem is unfulfilled. These issues of self communication process that can not be activated by the positive side, the source provided. This area is part of counseling and psychotherapy, art, music, photos, movies, and media-rich region and the activation of our own essential self, as well as interaction with others based on this relational issues serves to heal or recover. In this specification the media to convey to us or unconsciously inside us is the potential meaning (symbolism, visibility, etc.) a more direct picture of the face sex therapy techniques and the ongoing process of communication and would like to study aspects of the relationship. This paper studies the range of treatment techniques and photo images with cases occurring during treatment processes to be performed in terms of the communication is to try to study. First, our own self-concept, and based on this understanding of the meaning of self-representation and self-exposure is linked to the self-communication that have attempted a theoretical consideration. Second, for media communication, with understanding of social and cultural concepts, understanding of the phototherapy area photos, phototherapy process, and the relationship of communication are re-investigated. This phototherapy techniques that are applied to the image, along with examples that occur in the process of self communication and consultation and interview communication is performed in the course of treatment and was able to reaffirm the relationship. 우리 사회에는 다양한 커뮤니케이션 유형이 존재한다. 또한 그 유형의 특성에 따라 우리는 때로는 같은 방법으로 때로는 서로 다른 방법으로 커뮤니케이션 한다. 그리고 이러한 커뮤니케이션하는 방식이 현 사회에서의 우리의 삶의 방식이라 할 수 있다. 그러나 어찌 보면 다양한 형식의 뉴미디어 환경이 삶의 방식에 개입함으로써 상대적으로 면 대 면 상황이 제한되는 즉, 대인 커뮤니케이션 또는 집단 커뮤니케이션 등이 원활히 이루어지지 않는 문제가 발생함으로써 이에 따라 자아 커뮤니케이션 과정이 긍정적인 측면으로 활성화되지 못하는 원인을 제공했다고 할 수 있다. 이러한 부분은 상담 및 심리치료 영역에서 미술, 음악, 사진, 영화 등 다양한 미디어를 활용하여 우리 자신의 본질적인 자아 영역의 활성화뿐만 아니라 이를 바탕으로 타인과의 상호 관계적 문제점들을 치유하거나 회복시키는 작업을 하고 있다. 본 논고에서는 미디어가 우리에게 전달하는 또는 우리 내면에 무의식적으로 잠재되어 있는 의미(상징성, 가치성 등)들의 직면성이 보다 직접적인 사진치료기법들이 진행되는 과정과 커뮤니케이션과의 관계적 측면을 고찰하고자 한다. 본 논고의 연구 범위는 사진치료기법들과 이에 적용되어진 이미지 사례들을 통해 사진치료가 수행되어지는 동안 발생하는 과정들을 커뮤니케이션의 측면에서 그 관계적 고찰을 시도하는 것이다. 이에 따른 연구 방법은 다음과 같다. 첫째, 우리 자신의 자아개념에 대한 이해와 이를 바탕으로 자아표현의 의미와 자아노출로 연계되어지는 자아 커뮤니케이션과 미디어 커뮤니케이션에 대한 사회적 문화적 소통적 관점에서 이론적 고찰을 시도하였다. 둘째, 사진치료 영역에 대한 개념적 이해를 통해 사진치료 과정과 커뮤니케이션의 관계성을 재 고찰하였다. 이를 통해 사진치료기법에 적용되어지는 이미지 사례들과 더불어 그 과정에서 발생하는 자아 커뮤니케이션과 상담을 통한 치료과정에서 수행되는 대면 커뮤니케이션과의 관계성을 재확인할 수 있었다.