Extracorporeal Photochemotherapy Photopheresis

In this therapy regimen, which is established for the treatment of T-cell lymphoma, UV exposure is restricted to circulating leukocytes. They are irradiated by low-energy UVA (312-400 nm) after oral ingestion of a photosensitizing drug (such as 8-meth-oxypsoralen). A variety of studies have shown beneficial effects on cutaneous manifestations restricted to the skin or among systemic disease that allowed tapering or discontinuation of glucocorticosteroids or cytotoxic medication (Knobler et al. 1992, Richter et al. 1998, Russell-Jones 2000, Wollina and Looks 1999). In an uncontrolled study of 10 patients with SLE, eight completed the treatment. Seven of these patients showed significant reduction of disease activity on photopheresis on 2 consecutive days each month for 6 months and following alternate months for another 6 months (Knobler et al. 1992). A case report on a patient with disseminated DLE refractory to classic drug therapy demonstrated beneficial results on photopheresis (Richter et al. 1998). The need for appropriate technical facilities and experience as well as the time lapse before clinical results appear restrict this therapy to recalcitrant cases in which the other, classic therapy regimens have failed.

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