Ortonne J P, Forestier J Y, Souteyrand P, Thivolet J
Ann Dermatol Venereol. 1980 Mar;107(3):129-34.
One patient with urticaria pigmentosa was treated with PUVA. This treatment resulted in generalized tanning, decrease of Darier's sign and improvement of pruritus. However, the hyperpigmented macules overlying the mast cell infiltrates showed some persistence. This patient was subjected to biopsy of lesional skin before, during and at the end of oral photochemotherapy. During and after PUVA-therapy, histological examination revealed an increased number of free granules and a progressive decrease in the number of dermal mastocytes. Ultrastructurally necrotic cellular changes in the dermal mastocytes were observed. This suggests that PUVA-therapy may exercise its beneficial effect in urticaria pigmentosa by direct destruction of these cells. In addition, PUVA stimulates mast cell degranulation. Histaminaemia was estimated in this patient, before and after several irradiations. No significant changes were observed. Furthermore, histaminaemia was assayed in 15 patients with various dermatoses undergoing PUVA-therapy. No significant changes were observed. It is concluded that histaminaemia assayed using the fluorometric method of Shore et al. remains unchanged during oral photochemotherapy.
一名色素性荨麻疹患者接受了补骨脂素紫外线A光化学疗法(PUVA)治疗。该治疗导致全身皮肤变黑、达里埃氏征减轻以及瘙痒症状改善。然而,肥大细胞浸润上方的色素沉着斑仍有一定程度的持续存在。该患者在口服光化学疗法之前、期间及结束时均接受了皮损皮肤活检。在PUVA治疗期间及之后,组织学检查显示游离颗粒数量增加,真皮肥大细胞数量逐渐减少。超微结构观察发现真皮肥大细胞出现坏死性细胞变化。这表明PUVA疗法可能通过直接破坏这些细胞对色素性荨麻疹发挥有益作用。此外,PUVA刺激肥大细胞脱颗粒。对该患者在多次照射前后进行了组胺血症评估,未观察到显著变化。此外,对15例接受PUVA治疗的各种皮肤病患者进行了组胺血症检测,也未观察到显著变化。结论是,使用肖尔等人的荧光法检测的组胺血症在口服光化学疗法期间保持不变。