Related resources
Full-text held externally
- PMID: 19536141
- UKPMCID: 19536141
- DOI: 10.1038/jid.2009.156
Search for item elsewhere
University researcher(s)
Academic department(s)
Severely photosensitive psoriasis: a phenotypically defined patient subset.
Rutter, Kirsty J; Watson, Rachel E B; Cotterell, Lindsey F; Brenn, Thomas; Griffiths, Christopher E M; Rhodes, Lesley E
The Journal of investigative dermatology. 2009;129(12):2861-7.
Access to files
Full-text and supplementary files are not available from Manchester eScholar. Full-text is available externally using the following links:
Full-text held externally
- PMID: 19536141
- UKPMCID: 19536141
- DOI: 10.1038/jid.2009.156
Abstract
A subset of patients with chronic plaque psoriasis exhibits severely photosensitive psoriasis (PP) with a pronounced seasonal pattern, but the pathomechanism is not understood. We performed two related studies; first, a detailed clinical characterization of PP, and second, a controlled investigation exploring the underlying pathomechanisms through the assessment of disease onset after photoprovocation. Patients with PP (n=20) showed striking female predominance (19F:1M), very low mean age of psoriasis onset (11 years, range 2-24), family history of psoriasis (13/20), a strong HLA-Cw*0602 association (16/17), and a rapid abnormal clinical response to broadband UVA, comprising erythema+/-scaling plaques (17/20). Subsequently, patients with PP (n=10), non-PP (n=9), and healthy volunteers (n=11) were challenged with low-dose broadband UVA on 3 consecutive days, and serial biopsies were taken after 6 hours to 7 days and from unchallenged skin. Histological changes consistent with early psoriasis occurred in 4 of 10 PP patients, but in neither of the control groups, with significant dermal infiltration by neutrophils, CD4+, CD8+, and CD45RO+ cells at 24 h, accompanied by acanthosis. Thus, a phenotypically distinct subset of psoriasis has been characterized. In contrast with earlier assumptions, UV can provoke psoriasiform features rapidly de novo; a role for memory effector T cells is supported in the early phase.