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Ultrastructural Changes

Ken Hashimoto, MD; Hiromu Kohda, MD, PhD; Masanobu Kumakiri, MD; Steven L. Blender, MD; Isaac Willis, MD

Arch Dermatol. 1978;114(5):711-722.

Abstract
• Psoralen-ultraviolet light (PUVA)-treated psoriatic lesions were studied for ultrastructural changes. In early stages of treatment, sunburn cells in the epidermis and bizarre giant cells in the dermis were more frequently observed. When clinical improvement was apparent, these changes had subsided. Dermal abnormality in long-term therapy consisted of a thick perivascular coat of amorphous substance. No abnormality was found in the epidermal keratinocytes in long-term therapy, except a clustering and giant cell formation of melanocytes, a heavy melanization of keratinocytes, and hyperkeratosis. Low-dose initiation and slow increment of both 8-methoxypsoralen and UVA is probably a reasonable regimen for benign dermatoses such as psoriasis because it will allow enough time for the skin to become more protected, while the therapeutic results are as satisfactory as in a high-dose schedule.

(Arch Dermatol 114:711-722, 1978)

Author Affiliations
From the Veterans Administration Hospital and the Division of Dermatology, Department of Medicine, University of Tennessee Center for the Health Sciences, Memphis (Drs Hashimoto, Kohda, Kumakiri, and Blender); and the Division of Dermatology, Department of Medicine, Veterans Administration Hospital, Decataur, Ga (Dr Willis).

Footnotes
Accepted for publication Aug 30, 1977.

Reprint requests to Research Service (151), Veterans Administration Center, 4100 W Third St, Dayton, OH 45428 (Dr Hashimoto).

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