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Correspondence |

Limited Effects of UV-A1 Phototherapy in 3 Patients With Nephrogenic Systemic Fibrosis

Alexander Kreuter, MD; Thilo Gambichler, MD; Stefan M. Weiner, MD; Gisela Schieren, MD
Arch Dermatol. 2008;144(11):1527-1529. doi:10.1001/archderm.144.11.1527.
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Nephrogenic systemic fibrosis (NSF) is an emerging sclerodermalike disease that affects almost exclusively patients undergoing hemodialysis for end-stage renal disease (ESRD). Increasing evidence indicates that NSF is induced by gadolinium-based contrast agents commonly used in magnetic resonance imaging (MRI). Nephrogenic systemic fibrosis may result in significant morbidity and mortality, and a high proportion of patients end up in wheelchairs or become bedridden because of their progressive joint contractures. To date, no consistently effective therapy is available for NSF. Phototherapy with UV-A1, frequently used for other sclerotic skin diseases, has been reported to have beneficial effects in NSF.1 We herein report our results from 3 patients treated with UV-A1 phototherapy (Table).

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Pretreatment (A) and posttreatment (B) clinical photographs of patient 2 (index case) showing maximum leg extension. A, Significant contractures of both legs before initiation of UV-A1 phototherapy. B, Progressive nephrogenic systemic fibrosis with increasing contractures of the lower extremities.

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