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Objective assessment of photoageing effects using high-frequency ultrasound in PUVA-treated psoriasis patients
P-G Sator1, J B Schmidt, H Hönigsmann
1Department of Special and Environmental Dermatology, University of Vienna, General Hospital, Währinger Gürtel 18-20, A-1090 Vienna, Austria. paul.sator@khl.magwien.gv.at
Background:
Skin ageing can be differentiated into intrinsic (chronological) ageing, and photoageing due to chronic sun exposure. Photoageing is the superimposition of photodamage on the ageing process.
Objectives:
The aim of the study was to investigate possible differences between the skin of photochemotherapy (PUVA)-treated psoriasis patients and of untreated normal subjects using a high-frequency ultrasound system.
Methods:
A total of 124 volunteers (aged 21-88 years, median 52 years, 62 female, 62 male), 62 psoriasis patients who had received PUVA therapy and 62 healthy controls, were investigated. Skin thickness and a subepidermal low-echogenic band (SLEB), a parameter for photodamage, were measured in 12 different areas.
Results:
Female skin is thinner than male skin. The skin thickness values of PUVA patients were more markedly decreased than those of the controls for the older patients. There was a clear dependence of the occurrence of SLEB on PUVA therapy in psoriasis patients.
Conclusions:
Long-term PUVA treatment in psoriasis patients accelerates thinning of the skin in comparison to age-matched controls. The results show that ultrasonography is a sensitive method to investigate the effects of PUVA-induced skin ageing.