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Information Regarding Pseudocatalase and UVB Phototherapy

 

Narrow-band ultraviolet B (NBUVB) phototherapy is an effective therapy option for treatment of vitiligo. Studies show that NBUVB has improved outcomes when used in conjunction with pseudocatalase. NVUVB therapy induces tyrosinase, an enzyme that plays a role in melanin production. Tyrosinases are responsible for the conversion of tyrosine to dopaquinone, which in turn is converted to melanin(25). Melanin produces the color on the skin.

 

NBUVB and Pseudocatalase

In a study conducted in 2001 by Dr. Karin U. Schallreuter and team, 311-nm NBUVB activated pseudocatalalase led to four clinical findings(26):

1. the arrest of an active depigmentation process in 95% of the patients (Schallreuter et al, 1995, 1999)

2. the recovery of epidermal cells from intracellular vacuolation (Schallreuter et al, 1999; Tobin et al, 2000)

3. a successful repigmentation in 60%±65% of all patients treated so far (n > 700)

4. initiation of repigmentation independent of the duration of the disease (Schallreuter et al, 1995, 1999).

 

To use, apply a thin layer of pseudocatalase to affected areas twice daily for 24 weeks. Along with pseudocatalase, we recommend NBUVB (311-nm) phototherapy 10-30 minutes after application of cream, three times a week(21). The frequency and duration of therapy may be variable based on physician recommendation.

 

NBUVB monotherapy

When NBUVB therapy was used alone, repigmentation rates were between 41.6% and 100%(7). Brazzelli and team evaluated the use of UVB monotherapy on 60 patients. The patients were treated 2-3 times a week on nonconsecutive days at 311-nm wavelength. The treatment period was between 6 months to 2 years. Complete repigmentation was seen in 68% of lesions on the face, 57.89% on the neck, and 50% on the trunk(27).

UVB is a convenient therapy that can be administered with a home device. While the natural sunlight can also be a source of UV light, it may cause redness of the skin. UVB therapy can direct exposure to specific areas of the body. A study in a pediatric journal presented favorable results in children, considering it to be more effective and tolerable than PUVA therapy(28). Also, UVB phototherapy has been shown to be a better option than psoralen plus ultraviolet A (PUVA) phototherapy.

 

For additional information on how to purchase UV light therapy please visit www.homephototherapy.com

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Vitiligo Treatment References:

(1) Lebwohl MG, et al. (2006). Vitiligo. Treatment of Skin Disease: Comprehensive Therapeutic Strategies (2nd edition, pp. 683-687). Elsevier.

(2) NIH. (2010 Nov). What Is Vitiligo? Fast Facts: An Easy-to-Read Series of Publications for the Public. National Institute of Arthritis and Musculoskeletal and Skin Disease. Retrieved September 2, 2013 from http://www.niams.nih.gov/Health_Info/Vitiligo/vitiligo_ff.asp.

(3) Alikhan A, Felsten LM, Daly M, Petronic-Rosic V. Vitiligo: a comprehensive overview Part I. Introduction, epidemiology, quality of life, diagnosis, differential diagnosis, associations, histopathology, etiology, and work-up. J Am Acad Dermatol. 2011 Sep;65(3):473-91.

(4) AAD. (2013). Vitiligo: Signs and symptoms. American Academy of Dermatology. Retrieved September 2, 2013 from http://www.aad.org/dermatology-a-to-z/diseases-and-treatments/u---w/vitiligo/signs-symptoms

(5) AAD. (2013). Vitiligo: Who gets and causes. American Academy of Dermatology. Retrieved September 2, 2013 from http://www.aad.org/dermatology-a-to-z/diseases-and-treatments/u---w/vitiligo/who-gets-causes

(6) Gawkrodger DJ. Pseudocatalase and narrowband ultraviolet B for vitiligo: clearing the picture. Br J Dermatol. 2009 Oct;161(4):721-2.

(7) Felsten LM, Alikhan A, Petronic-Rosic V. Vitiligo: a comprehensive overview Part II: treatment options and approach to treatment. J Am Acad Dermatol. 2011 Sep;65(3):493-514.

(8) Silverberg JI, Silverberg AI, Malka E, Silverberg NB. A pilot study assessing the role of 25 hydroxy vitamin D levels in patients with vitiligo vulgaris. J Am Acad Dermatol. 2010 Jun;62(6):937-41.

(9) Gawkrodger DJ, Ormerod AD, Shaw L et al. Guideline for the diagnosis and management of vitiligo. Br J Dermatol 2008; 159: 1051-76.

(10) AAD. (2013). Vitiligo: Diagnosis, treatment, and outcome. American Academy of Dermatology. Retrieved September 2, 2013 from http://www.aad.org/dermatology-a-to-z/diseases-and-treatments/u---w/vitiligo/diagnosis-treatment

(11) Schallreuter KU, Moore J, Behrens-Williams S, Panske A, Harari M. Rapid initiation of repigmentation in vitiligo with Dead Sea climatotherapy in combination with pseudocatalase (PC-KUS). Int J Dermatol. 2002 Aug;41(8):482-7.

(12) AVRF. (2013). Medical treatments. American Vitiligo Research Foundation. Retrieved September 2, 2013 from http://www.avrf.org/treatments/medical.htm

(13) Kriegel MA, Manson JE, Costenbader KH. Does vitamin D affect risk of developing autoimmune disease?: a systematic review. Semin Arthritis Rheum. 2011 Jun;40(6):512-531.

(14) Travis LB, Silverberg NB. Calcipotriene and corticosteroid combination therapy for vitiligo. Pediatr Dermatol 2004;21: 495-8.

(15) AVRF. (2013). Surgical treatments. American Vitiligo Research Foundation. Retrieved September 2, 2013 from http://www.avrf.org/treatments/surgical.htm

(16) Papadopoulos L, Bor R, Legg C. Coping with the disfiguring effects of vitiligo: a preliminary investigation into the effects of cognitive-behavioural therapy. Br J Med Psychol 1999; 72(pt 3):385-96.

(17) Schallreuter KU, Moore J, Behrens-Williams S, Panske A, Harari M. Rapid initiation of repigmentation in vitiligo with Dead Sea climatotherapy in combination with pseudocatalase (PC-KUS). Int J Dermatol. 2002 Aug;41(8):482-7.

(18) Schallreuter KU, Wood JM, Lemke KR, Levenig C. Treatment of vitiligo with a topical application of pseudocatalase and calcium in combination with short-term UVB exposure: a case study on 33 patients. Dermatology. 1995;190(3):223-9.

(19) Gawkrodger DJ. Pseudocatalase and narrowband ultraviolet B for vitiligo: clearing the picture. Br J Dermatol. 2009 Oct;161(4):721-2.

(20) Schallreuter KU, Krüger C, Würfel BA, Panske A, Wood JM. From basic research to the bedside: efficacy of topical treatment with pseudocatalase PC-KUS in 71 children with vitiligo. Int J Dermatol. 2008 Jul;47(7):743-53.

(21) Bakis-Petsoglou S, Le Guay JL, Wittal R. A randomized, double-blinded, placebo-controlled trial of pseudocatalase cream and narrowband ultraviolet B in the treatment of vitiligo. Br J Dermatol. 2009 Oct;161(4):910-7.

(22) Schallreuter KU. Effectiveness of pseudocatalase formulations in vitiligo. Clin Exp Dermatol. 2003 Sep;28(5):562-3.

(23) Schallreuter KU, Salem MA, Holtz S, Panske A. Basic evidence for epidermal H2O2/ONOO--mediated oxidation/nitration in segmental vitiligo is supported by repigmentation of skin and eyelashes after reduction of epidermal H2O2 with topical NB-UVB-activated pseudocatalase PC-KUS. FASEB J. 2013 Aug;27(8):3113-22.

(24) Bazian. (2013, May 12). No evidence of cure to prevent hair going grey. NIH Behind the headlines. Retrieved on September 2, 2013 from http://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2013-05-12-no-evidence-of-cure-to-prevent-hair-going-grey/

(25) Genes. (2013, Sept 23). TYR. Genetics Homes Reference. Retrieved September 25, 2013 from http://ghr.nlm.nih.gov/gene/TYR

(26) Schallreuter KU, Moore J, Wood JM, Beazley WD, Peters EM, Marles LK, Behrens-Williams SC, Dummer R, Blau N, Thöny B. Epidermal H(2)O(2) accumulation alters tetrahydrobiopterin (6BH4) recycling in vitiligo: identification of a general mechanism in regulation of all 6BH4-dependent processes? J Invest Dermatol. 2001 Jan;116(1):167-74.

(27) Brazzelli V, Antoninetti M, Palazzini S, Barbagallo T, De Silvestri A, Borroni G. Critical evaluation of the variants influencing the clinical response of vitiligo: study of 60 cases treated with ultraviolet B narrow-band phototherapy. J Eur Acad Dermatol Venereol 2007;21:1369-74.

(28) Percivalle S, Piccinno R, Caccialanza M, Forti S. Narrowband ultraviolet B phototherapy in childhood vitiligo: evaluation of results in 28 patients. Pediatr Dermatol. 2012 Mar-Apr;29(2):160-5.

(29) Patel DC, Evans AV, Hawk JL. Topical pseudocatalase mousse and narrowband UVB phototherapy is not effective for vitiligo: an open, single-centre study. Clin Exp Dermatol. 2002 Nov;27(8):641-4.

(30) www.vitiligosupport.com/whatis.cfm  Accessed April 18, 2005

(31) http://www.niams.nih.gov/hi/topics/vitiligo/vitiligo.htm  Accessed April 18, 2005

(32) http://www.homephototherapy.com/vit-pcat.htm  Accessed April 18, 2005

(33) http://www.brad.ac.uk/acad/biomed/STAFF/KUS/home.html  Accessed April 19,2005

(34) Schallreuter KU, Wood JM, Lemke KR, Levenig C.  Treatment of vitiligo with a topical application of pseudoctalase and calcium in combination with short-term UVB exposure: a case study on 33 patients.  Dermatology.  1995;190(3):223-9.

(35) Schallreuter KU, Moore J, Behrens-Williams S, Panske A, Harari M.  Rapid initiation of repigmentation in vitiligo with Dead Sea climatotherapy in combination with pseudocatalase (PC-KUS).  International Journal of Dermatology.  2002;41(8):482-7.