Long-wavelength ultraviolet A (UVA-1) phototherapy for the treatment of patients with atopic dermatitis

Cover Page

Cite item

Full Text

Abstract

One of the methods of therapy for atopic dermatitis is long-wavelength ultraviolet therapy A (UVA-1- therapy). This review aims to provide the mechanisms of action of UVA-1-therapy an overview about the effectiveness of UVA-1-therapy in patients with atopic dermatitis taking into account factors that can affect the effectiveness of treatment — radiation dose, skin phototype of patients, concomitant drug therapy. The available data on a decrease in the severity of atopic dermatitis as a result of the course of UVA-1-therapy and on a decrease in the severity of itching in patients are presented. The data on the rate of onset of the therapeutic effect of UVA-1-therapy and the duration of its maintenance are considered. The safety of UVA-1-therapy is discussed, and the most frequent undesirable effects — a feeling of warmth, fever, itching, hyperpigmentation, are given. The possibility of developing side effects requiring discontinuation of treatment is assessed. The data obtained indicate the effectiveness and safety of the UFA-1-radiation in the treatment of patients with moderate-to-severe atopic dermatitis.

About the authors

A. E. Karamova

State Research Center of Dermatovenereology and Cosmetology

Email: karamova@cnikvi.ru
ORCID iD: 0000-0003-3805-8489
SPIN-code: 3604-6491

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

V. V. Chikin

State Research Center of Dermatovenereology and Cosmetology

Author for correspondence.
Email: chikin@cnikvi.ru
ORCID iD: 0000-0002-9688-2727
SPIN-code: 3385-4723

MD, Dr. Sci. (Med.)

Russian Federation, Moscow

A. A. Kubanov

State Research Center of Dermatovenereology and Cosmetology

Email: alex@cnikvi.ru
ORCID iD: 0000-0002-7625-0503
SPIN-code: 8771-4990

MD, Dr. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences

Russian Federation, Moscow

L. K. Davletbaeva

State Research Center of Dermatovenereology and Cosmetology

Email: lesya-gl@mail.ru
ORCID iD: 0000-0003-4952-0800
Russian Federation, Moscow

References

  1. Werfel T, Allam JP, Biedermann T, Eyerich K, Gilles S, Guttman-Yassky E, et al. Cellular and molecular immunologic mechanisms in patients with atopic dermatitis. J Allergy Clin Immunol. 2016;138(2):336–349. doi: 10.1016/j.jaci.2016.06.010
  2. Biedermann T, Skabytska Y, Kaesler S, Volz T. Regulation of T cell immunity in atopic dermatitis by microbes: The Yin and Yang of cutaneous inflammation. Front Immunol. 2015;13;6:353. doi: 10.3389/fimmu.2015.00353
  3. Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. Lancet. 2020;396(10247):345–360. doi: 10.1016/S0140-6736(20)31286-1
  4. Luger T, Amagai M, Dreno B, Dagnelie MA, Liao W, Kabashima K, et al. Atopic dermatitis: Role of the skin barrier, environment, microbiome, and therapeutic agents. J Dermatol Sci. 2021;102(3):142–157. doi: 10.1016/j.jdermsci.2021.04.007
  5. Leung DY, Bhan AK, Schneeberger EE, Geha RS. Characterization of the mononuclear cell infiltrate in atopic dermatitis using monoclonal antibodies. J Allergy Clin Immunol. 1983;71(1 Pt 1):47–56. doi: 10.1016/0091-6749(83)90546-8
  6. Leung DY, Guttman-Yassky E. Deciphering the complexities of atopic dermatitis: shifting paradigms in treatment approaches. J Allergy Clin Immunol. 2014;134(4):769–779. doi: 10.1016/j.jaci.2014.08.008
  7. Hamid Q, Boguniewicz M, Leung DY. Differential in situ cytokine gene expression in acute versus chronic atopic dermatitis. J Clin Invest. 1994;94:870–876. doi: 10.1172/JCI117408
  8. Hamid Q, Naseer T, Minshall EM, Song YL, Boguniewicz M, Leung DY. In vivo expression of IL-12 and IL-13 in atopic dermatitis. J Allergy Clin Immunol. 1996;98(1):225–231. doi: 10.1016/s0091-6749(96)70246-4
  9. Czarnowicki T, Krueger JG, Guttman-Yassky E. Skin barrier and immune dysregulation in atopic dermatitis: an evolving story with important clinical implications. J Allergy Clin Immunol Pract. 2014;2(4):371–379. doi: 10.1016/j.jaip.2014.03.006
  10. Oliva M, Renert-Yuval Y, Guttman-Yassky E. The ‘omics’ revolution: redefining the understanding and treatment of allergic skin diseases. Curr Opin Allergy Clin Immunol. 2016;16(5):469-476.
  11. doi: 10.1097/ACI.0000000000000306
  12. Gittler JK, Shemer A, Suárez-Fariñas M, Fuentes-Duculan J, Gulewicz KJ, Wang CQ, et al. Progressive activation of T(H)2/T(H)22 cytokines and selective epidermal proteins characterizes acute and chronic atopic dermatitis. J Allergy Clin Immunol. 2012;130(6):1344–1354. doi: 10.1016/j.jaci.2012.07.012
  13. Dhingra N, Guttman-Yassky E. A possible role for IL-17A in establishing Th2 inflammation in murine models of atopic dermatitis. J Invest Dermatol. 2014;134(8):2071–2074. doi: 10.1038/jid.2014.141
  14. Thepen T, Langeveld-Wildschut EG, Bihari IC, van Wichen DF, van Reijsen FC, Mudde GC, et al. Biphasic response against aeroallergen in atopic dermatitis showing a switch from an initial TH2 response to a TH1 response in situ: an immunocytochemical study. J Allergy Clin Immunol. 1996;97(3):828–837. doi: 10.1016/s0091-6749(96)80161-8
  15. Drislane C, Irvine AD. The role of filaggrin in atopic dermatitis and allergic disease. Ann Allergy Asthma Immunol. 2020;124(1):36–43. doi: 10.1016/j.anai.2019.10.008
  16. Danso MO, van Drongelen V, Mulder A, van Esch J, Scott H, van Smeden J, et al. TNF-alpha and Th2 cytokines induce atopic dermatitis-like features on epidermal differentiation proteins and stratum corneum lipids in human skin equivalents. J Invest Dermatol. 2014;134(7):1941–1950. doi: 10.1038/jid.2014.83
  17. Kim BE, Leung DY, Boguniewicz M, Howell MD. Loricrin and involucrin expression is down-regulated by Th2 cytokines through STAT-6. Clin Immunol. 2008;126(3):332–337. doi: 10.1016/j.clim.2007.11.006
  18. Gutowska-Owsiak D, Schaupp AL, Salimi M, Selvakumar TA, McPherson T, Taylor S, et al. IL-17 downregulates filaggrin and affects keratinocyte expression of genes associated with cellular adhesion. Exp Dermatol. 2012;21(2):104–110. doi: 10.1111/j.1600-0625.2011.01412.x
  19. Howell MD, Kim BE, Gao P, Grant AV, Boguniewicz M, Debenedetto A, et al. Cytokine modulation of atopic dermatitis filaggrin skin expression. J Allergy Clin Immunol. 2007;120(1):150–155. doi: 10.1016/j.jaci.2007.04.031
  20. Egawa G, Kabashima K. Multifactorial skin barrier deficiency and atopic dermatitis: Essential topics to prevent the atopic march. J Allergy Clin Immunol. 2016;138(2):350–358. doi: 10.1016/j.jaci.2016.06.002
  21. Sehra S, Yao Y, Howell MD, Nguyen ET, Kansas GS, Leung DY, et al. IL-4 regulates skin homeostasis and the predisposition toward allergic skin inflammation. J Immunol. 2010;184(6):3186–3190. doi: 10.4049/jimmunol.0901860
  22. Gutowska-Owsiak D, Schaupp AL, Salimi M, Taylor S, Ogg GS. Interleukin-22 downregulates filaggrin expression and affects expression of profilaggrin processing enzymes. Br J Dermatol. 2011;165(3):492–498. doi: 10.1111/j.1365-2133.2011.10400.x
  23. Ouyang W, Rutz S, Crellin NK, Valdez PA, Hymowitz SG. Regulation and functions of the IL-10 family of cytokines in inflammation and disease. Annu Rev Immunol. 2011;29:71–109. doi: 10.1146/annurev-immunol-031210-101312
  24. Saraiva M, O’Garra A. The regulation of IL-10 production by immune cells. Nat Rev Immunol. 2010;10(3):170–181. doi: 10.1038/nri2711
  25. Brandt EB, Sivaprasad U. Th2 Cytokines and Atopic Dermatitis. J Clin Cell Immunol. 2011:2(3):110. doi: 10.4172/2155-9899.1000110
  26. Darling AR, Freyschmidt EJ, Burton OT, Koleoglou KJ, Oyoshi MK, Oettgen HC. IL-10 suppresses IL-17-mediated dermal inflammation and reduces the systemic burden of vaccinia virus in a mouse model of eczema vaccinatum. Clin Immunol. 2014;150(2):153–160. doi: 10.1016/j.clim.2013.11.010
  27. Niwa Y. Elevated RANTES levels in plasma or skin and decreased plasma IL-10 levels in subsets of patients with severe atopic dermatitis. Arch Dermatol. 2000;136(1):125–126. doi: 10.1001/archderm.136.1.125
  28. Seneviratne SL, Jones L, Bailey AS, Black AP, Ogg GS. Severe atopic dermatitis is associated with a reduced frequency of IL-10 producing allergen-specific CD4+ T cells. Clin Exp Dermatol. 2006;31(5):689–694. doi: 10.1111/j.1365-2230.2006.02172.x
  29. Dunstan JA, Hale J, Breckler L, Lehmann H, Weston S, Richmond P, et al. Atopic dermatitis in young children is associated with impaired interleukin-10 and interferon-gamma responses to allergens, vaccines and colonizing skin and gut bacteria. Clin Exp Allergy. 2005;35(10):1309–1317. doi: 10.1111/j.1365-2222.2005.02348.x
  30. Oh SH, Park CO, Wu WH, Kim JY, Jin S, Byamba D, et al. Corticotropin-releasing hormone downregulates IL-10 production by adaptive forkhead box protein 3-negative regulatory T cells in patients with atopic dermatitis. J Allergy Clin Immunol. 2012;129(1):151–159. doi: 10.1016/j.jaci.2011.09.008
  31. York NR, Jacobe HT. UVA1 phototherapy: a review of mechanism and therapeutic application. Int J Dermatol. 2010;49(6):623–630. doi: 10.1111/j.1365-4632.2009.04427.x
  32. Singer S, Berneburg M. Phototherapie. J Dtsch Dermatol Ges. 2018;16(9):1120–1131. doi: 10.1111/ddg.13646_g
  33. Vieyra-Garcia PA, Wolf P. A deep dive into UV-based phototherapy: Mechanisms of action and emerging molecular targets in inflammation and cancer. Pharmacol Ther. 2021;222:107784. doi: 10.1016/j.pharmthera.2020.107784
  34. Mutzhas MF, Holzle E, Hofmann C, Plewig G. A new apparatus with high radiation energy between 320-460 nm: physical description and dermatological applications. J Invest Dermatol. 1981;76(1):42–47. doi: 10.1111/1523-1747.ep12524813
  35. Gambichler T, Terras S, Kreuter A. Treatment regimens, protocols, dosage, and indications for UVA1 phototherapy: Facts and controversies. Clin Dermatol. 2013;31(4):438–454. doi: 10.1016/j.clindermatol.2013.01.011
  36. Plewig G, Hofmann C, Braun-Falco O, Nath G, Kreitmair A. A new apparatus for the delivery of high intensity UVA and UVA+UVB irradiation, and some dermatological applications. Br J Dermatol. 1978;98(1):15–24. doi: 10.1111/j.1365-2133.1978.tb07328.x
  37. Krutmann J. Phototherapy for atopic dermatitis. Clin Exp Dermatol. 2000;25(7):552–558. doi: 10.1046/j.1365-2230.2000.00700.x
  38. Gambichler T, Majert J, Pljakic A, Rooms I, Wolf P. Determination of the minimal erythema dose for ultraviolet A1 radiation. Br J Dermatol. 2017;177(1):238–244. doi: 10.1111/bjd.15245
  39. Grabbe J, Welker P, Humke S, Grewe M, Schöpf E, Henz BM, Krutmann J. High-dose ultraviolet A1 (UVA1), but not UVA/UVB therapy, decreases IgE-binding cells in lesional skin of patients with atopic eczema. J Invest Dermatol. 1996;107(3):419–422. doi: 10.1111/1523-1747.ep12363402
  40. Besaratinia A, Kim SI, Bates SE, Pfeifer GP. Riboflavin activated by ultraviolet A1 irradiation induces oxidative DNA damage-mediated mutations inhibited by vitamin C. Proc Natl Acad Sci USA. 2007;104(14):5953–5958. doi: 10.1073/pnas.0610534104
  41. Godar DE. UVA1 radiation triggers two different final apoptotic pathways. J Invest Dermatol. 1999;112(1):3–12. doi: 10.1046/j.1523-1747.1999.00474.x
  42. Guhl S, Hartmann K, Tapkenhinrichs S, Smorodchenko A, Grützkau A, Henz BM, Zuberbier T. Ultraviolet irradiation induces apoptosis in human immature, but not in skin mast cells. J Invest Dermatol. 2003;121(4):837–844. doi: 10.1046/j.1523-1747.2003.12480.x
  43. Новиков В.Е., Левченкова О.С. Митохондриальные мишени для фармакологической регуляции адаптации клетки к воздействию гипоксии. Обзоры по клинической фармакологии и лекарственной терапии. 2014;12(2):28–35. [Novikov VE, Levchenkova OS. Mitochondrial targets for pharmacological regulation of cell adaptation to hypoxia. Reviews on Clinical Pharmacology and Drug Therapy. 2014;12(2):28–35 (In Russ.)]
  44. Godar DE. Preprogrammed and programmed cell death mechanisms of apoptosis: UV-induced immediate and delayed apoptosis. Photochem Photobiol. 1996;63(6):825–830. doi: 10.1111/j.1751-1097.1996.tb09638.x
  45. Tyrrell R.M. Ultraviolet radiation and free radical damage to skin. Biochem Soc Symp. 1995;61:47–53. doi: 10.1042/bss0610047
  46. Skov L, Hansen H, Allen M, Villadsen L, Norval M, Barker JN, et al. Contrasting effects of ultraviolet A1 and ultraviolet B exposure on the induction of tumour necrosis factor-alpha in human skin. Br J Dermatol. 1998;138(2):216–220. doi: 10.1046/j.1365-2133.1998.02063.x
  47. Krutmann J, Grewe M. Involvement of cytokines, DNA damage, and reactive oxygen intermediates in ultraviolet radiation-induced modulation of intercellular adhesion molecule-1 expression. J Invest Dermatol. 1995;105(1 Suppl):67S–70S. doi: 10.1111/1523-1747.ep12316095
  48. Szegedi A, Simics E, Aleksza M, Horkay I, Gaál K, Sipka S, et al. Ultraviolet-A1 phototherapy modulates Th1/Th2 and Tc1/Tc2 balance in patients with systemic lupus erythematosus. Rheumatology (Oxford). 2005;44(7):925–931. doi: 10.1093/rheumatology/keh643
  49. Grewe M, Gyufko K, Krutmann J. Interleukin-10 production by cultured human keratinocytes: regulation by ultraviolet B and ultraviolet A1 radiation. J Invest Dermatol. 1995;104(1):3–6. doi: 10.1111/1523-1747.ep12613446
  50. Gambichler T, Othlinghaus N, Tomi NS, Holland-Letz T, Boms S, Skrygan M, et al. Medium-dose ultraviolet (UV) A1 vs. narrowband UVB phototherapy in atopic eczema: a randomized crossover study. Br J Dermatol 2009;160(3):652–658. doi: 10.1111/j.1365-2133.2008.08984.x
  51. Tzaneva S, Kittler H, Holzer G, Reljic D, Weber M, Hönigsmann H, Tanew A. 5-Methoxypsoralen plus ultraviolet (UV) A is superior to medium-dose UVA1 in the treatment of severe atopic dermatitis: A randomized crossover trial. Br J Dermatol. 2010;162(3):655–660. doi: 10.1111/j.1365-2133.2009.09514.x
  52. von Kobyletzki G, Pieck C, Hoffmann K, Freitag M, Altmeyer P. Medium-dose UVA1 cold-light phototherapy in the treatment of severe atopic dermatitis. J Am Acad Dermatol. 1999;41(6):931–937. doi: 10.1016/s0190-9622(99)70249-5
  53. von Kobyletzki G, Freitag M, Herde M, Höxtermann S, Stücker M, Hoffmann K, Altmeyer P. Phototherapie bei schwerer atopischer Dermatitis. Vergleich zwischen herkömmlicher UVA1-Therapie, UVA1-Kaltlicht- und kombinierter UVA-UVB-Therapie. Hautarzt. 1999;50(1):27–33. doi: 10.1007/s001050050860
  54. Krutmann J, Czech W, Diepgen T, Niedner R, Kapp A, Schöpf E. High-dose UVA1 therapy in the treatment of patients with atopic dermatitis. J Am Acad Dermatol. 1992;26(2 Pt 1):225–230. doi: 10.1016/0190-9622(92)70031-a
  55. Krutmann J, Diepgen TL, Luger TA, Grabbe S, Meffert H, Sönnichsen N, et al. High-dose UVA1 therapy for atopic dermatitis: Results of a multicenter trial. J Am Acad Dermatol. 1998;38(4):589–593. doi: 10.1016/s0190-9622(98)70123-9
  56. Osmola-Mańkowska A, Polańska A, Silny W, Żaba R, Adamski Z, Dańczak-Pazdrowska A. Topical tacrolimus vs medium-dose ultraviolet A1 phototherapy in the treatment of atopic dermatitis — a preliminary study in relation to parameters of the epidermal barrier function and high-frequency ultrasonography. Eur Rev Med Pharmacol Sci. 2014;18(24):3927–3934.
  57. Tzaneva S, Seeber A, Schwaiger M, Hönigsmann H, Tanew A. High-dose versus medium-dose UVA1 phototherapy for patients with severe generalized atopic dermatitis. J Am Acad Dermatol. 2001;45(4):503–507. doi: 10.1067/mjd.2001.114743
  58. Pacifico A, Iacovelli P, Damiani G, Ferraro C, Cazzaniga S, Conic RR, et al. 'High dose' vs. 'medium dose' UVA1 phototherapy in italian patients with severe atopic dermatitis. J Eur Acad Dermatol Venereol. 2019;33(4):718–724. doi: 10.1111/jdv.15362
  59. Kowalzick L, Kleinheinz A, Weichenthal M, Neuber K, Köhler I, Grosch J, et al. Low dose versus medium dose UV-A1 treatment in severe atopic dermatitis. Acta Derm Venereol. 1995; 75 (1): 43–45. doi: 10.2340/00015555754345
  60. Dittmar HC, Pflieger D, Schopf E, Simon JC. UVA1-Phototherapie. Pilotstudie zur Dosisfindung bei der bei akut exazerbierten atopischen Dermatitis. Hautarzt. 2001;52(5):423–427. doi: 10.1007/s001050051336
  61. Бакулев А.Л., Платонова А.Н. Отдаленные результаты применения УФА-1-терапии в комплексном лечении атопического дерматита. Бюллетень медицинских интернет-конференций (ISSN 2224‐6150) 2013;3(6):961–963. [Bakulev AL, Platonova AN. Long-term results of usage of UVA-1-therapy in complex treatment of atopic dermatitis. Bulletin of Medical Internet Conferences. 2013;3(6):961–963 (In Russ.)]
  62. Majoie IM, Oldhoff JM, van Weelden H, Laaper-Ertmann M, Bousema MT, Sigurdsson V, et al. Narrowband ultraviolet B and medium-dose ultraviolet A1 are equally effective in the treatment of moderate to severe atopic dermatitis. J Am Acad Dermatol. 2009;60(1):77–84. doi: 10.1016/j.jaad.2008.08.048
  63. Legat FJ, Hofer A, Brabek E, Quehenberger F, Kerl H, Wolf P. Narrowband UV-B vs medium-dose UV-A1 phototherapy in chronic atopic dermatitis. Arch Dermatol. 2003;139:223–224. doi: 10.1001/archderm.139.2.223
  64. Олисова О.Ю., Владимиров В.В., Мураховская Е.К. Фототерапия атопического дерматита УФА-лучами 370 нм. Российский журнал кожных и венерических болезней. 2013;6:22–27. [Olisova OYu, Vladimirov VV, Murakhovskaya EK. UVA 370 nm phototherapy of atopic dermatitis. Russian Journal of Skin and Venereal Diseases. 2013;6:22–27 (In Russ.)]
  65. Abeck D, Schmidt T, Fesq H, Strom K, Mempel M, Brockow K, et al. Long-term efficacy of medium-dose UVA1 phototherapy in atopic dermatitis. J Am Acad Dermatol. 2000;42(2 Pt 1):254–257. doi: 10.1016/S0190-9622(00)90134-8
  66. Gambichler T, Kreuter A, Tomi NS, Othlinghaus N, Altmeyer P, Skrygan M. Gene expression of cytokines in atopic eczema before and after ultraviolet A1 phototherapy. Br J Dermatol. 2008;158(5):1117–1120. doi: 10.1111/j.1365-2133.2008.08498.x
  67. Bogaczewicz J, Malinowska K, Sysa-Jedrzejowska A, Wozniacka A. Medium-dose ultraviolet A1 phototherapy improves SCORAD index and increases mRNA expression of interleukin-4 without direct effect on human β defensin-1, interleukin-10, and interleukin-31. Int J Dermatol. 2016;55(7):e380–e385. doi: 10.1111/ijd.13213
  68. Bogaczewicz J, Malinowska K, Sysa-Jedrzejowska A, Wozniacka A. Medium-dose ultraviolet A1 phototherapy and mRNA expression of TSLP, TARC, IL-5, and IL-13 in acute skin lesions in atopic dermatitis. Int J Dermatol. 2016;55(8):856–863. doi: 10.1111/ijd.12992
  69. Malinowska K, Wozniacka A, Bogaczewicz J. The impact of medium dose UVA1 phototherapy on pruritus, DLQI and SCORAD index in patients with atopic dermatitis. Postepy Dermatol Alergol. 2020;37(6):962–967. doi: 10.5114/ada.2019.88465
  70. Park JB, Jang JY, Kwon DI, Seong SH, Suh KS, Jang MS. The effectiveness of high-dose ultraviolet A-1 phototherapy for acute exacerbation of atopic dermatitis in Asians. Photodermatol Photoimmunol Photomed. 2020;36(4):263–270. doi: 10.1111/phpp.12546
  71. Авдиенко И.Н., Кубанов А.А. Эффективность дальней длинноволновой ультрафиолетовой терапии у больных атопическим дерматитом. Вестник дерматологии и венерологии. 2009;3:61–63. [Avdienko IN, Kubanov AA. Efficiency of long-wave ultraviolet therapy in patients with atopic dermatitis. Vestnik Dermatologii i Venerologii. 2009;3:61–63 (In Russ.)]
  72. Tajima T, Ibe M, Matsushita T, Kamide R. A variety of skin responses to ultraviolet irradiation in patients with atopic dermatitis. J Dermatol Sci. 1998;17(2):101–107. doi: 10.1016/s0923-1811(97)00080-7
  73. Valbuena Mesa MC, Nova Villanueva JA, Sánchez Vanegas G. Minimal erythema dose: Correlation with Fitzpatrick skin type and concordance between methods of erythema assessment in a patient sample in Colombia. Actas Dermosifiliogr (Engl Ed). 2020;111(5):390–397. doi: 10.1016/j.ad.2019.12.003
  74. Welti M, Ramelyte E, Dummer R, Imhof L. Evaluation of the minimal erythema dose for UVB and UVA in context of skin phototype and nature of photodermatosis. Photodermatol Photoimmunol Photomed. 2020;36(3):200–207. doi: 10.1111/phpp.12537
  75. Beattie PE, Dawe RS, Ferguson J, Ibbotson SH. Dose-response and time-course characteristics of UV-A1 erythema. Arch Dermatol. 2005;141(12):1549–1555. doi: 10.1001/archderm.141.12.1549
  76. Kroft EB, Berkhof NJ, van de Kerkhof PC, Gerritsen RM, de Jong EM. Ultraviolet A phototherapy for sclerotic skin diseases: a systematic review. J Am Acad Dermatol. 2008;59(6):1017–1030. doi: 10.1016/j.jaad.2008.07.042
  77. Gambichler T. Management of atopic dermatitis using photo(chemo) therapy. Arch Dermatol Res. 2009;301(3):197–203. doi: 10.1007/s00403-008-0923-5
  78. Dawe RS. Ultraviolet A1 phototherapy. Br J Dermatol. 2003;148(4):626–637. doi: 10.1046/j.1365-2133.2003.05261.x
  79. Gambichler T, Al-Muhammadi R, Boms S. Immunologically mediated photodermatoses: diagnosis and treatment. Am J Clin Dermatol. 2009;10(3):169–180. doi: 10.2165/00128071-200910030-00003
  80. ten Berge O, van Weelden H, Bruijnzeel-Koomen CA, de Bruin-Weller MS, Sigurdsson V. Throwing a light on photosensitivity in atopic dermatitis: a retrospective study. Am J Clin Dermatol. 2009;10(2):119–123. doi: 10.2165/00128071-200910020-00004
  81. Schempp CM, Effinger T, Czech W, Krutmann J, Simon JC, Schöpf E. Charakterisierung von Non-Respondern bei der hochdosierten UVA1-Therapie der akut exazerbierten Atopischen Dermatitis. Hautarzt. 1997;48(2):94–99. doi: 10.1007/s001050050552
  82. Brem R, Daehn I, Karran P. Efficient DNA interstrand crosslinking by 6-thioguanine and UVA radiation. DNA Repair (Amst). 2011;10(8):869–876. doi: 10.1016/j.dnarep.2011.05.010
  83. Brem R, Karran P. Multiple forms of DNA damage caused by UVA photoactivation of DNA 6-thioguanine. Photochem Photobiol. 2011;88(1):5–13. doi: 10.1111/j.1751-1097.2011.01043.x
  84. Amber T, Tabassum S. Cyclosporin in dermatology: A practical compendium. Dermatol Ther. 2020;33(6):e13934. doi: 10.1111/dth.13934

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2021 Karamova A.E., Chikin V.V., Kubanov A.A., Davletbaeva L.K.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Согласие на обработку персональных данных с помощью сервиса «Яндекс.Метрика»

1. Я (далее – «Пользователь» или «Субъект персональных данных»), осуществляя использование сайта https://journals.rcsi.science/ (далее – «Сайт»), подтверждая свою полную дееспособность даю согласие на обработку персональных данных с использованием средств автоматизации Оператору - федеральному государственному бюджетному учреждению «Российский центр научной информации» (РЦНИ), далее – «Оператор», расположенному по адресу: 119991, г. Москва, Ленинский просп., д.32А, со следующими условиями.

2. Категории обрабатываемых данных: файлы «cookies» (куки-файлы). Файлы «cookie» – это небольшой текстовый файл, который веб-сервер может хранить в браузере Пользователя. Данные файлы веб-сервер загружает на устройство Пользователя при посещении им Сайта. При каждом следующем посещении Пользователем Сайта «cookie» файлы отправляются на Сайт Оператора. Данные файлы позволяют Сайту распознавать устройство Пользователя. Содержимое такого файла может как относиться, так и не относиться к персональным данным, в зависимости от того, содержит ли такой файл персональные данные или содержит обезличенные технические данные.

3. Цель обработки персональных данных: анализ пользовательской активности с помощью сервиса «Яндекс.Метрика».

4. Категории субъектов персональных данных: все Пользователи Сайта, которые дали согласие на обработку файлов «cookie».

5. Способы обработки: сбор, запись, систематизация, накопление, хранение, уточнение (обновление, изменение), извлечение, использование, передача (доступ, предоставление), блокирование, удаление, уничтожение персональных данных.

6. Срок обработки и хранения: до получения от Субъекта персональных данных требования о прекращении обработки/отзыва согласия.

7. Способ отзыва: заявление об отзыве в письменном виде путём его направления на адрес электронной почты Оператора: info@rcsi.science или путем письменного обращения по юридическому адресу: 119991, г. Москва, Ленинский просп., д.32А

8. Субъект персональных данных вправе запретить своему оборудованию прием этих данных или ограничить прием этих данных. При отказе от получения таких данных или при ограничении приема данных некоторые функции Сайта могут работать некорректно. Субъект персональных данных обязуется сам настроить свое оборудование таким способом, чтобы оно обеспечивало адекватный его желаниям режим работы и уровень защиты данных файлов «cookie», Оператор не предоставляет технологических и правовых консультаций на темы подобного характера.

9. Порядок уничтожения персональных данных при достижении цели их обработки или при наступлении иных законных оснований определяется Оператором в соответствии с законодательством Российской Федерации.

10. Я согласен/согласна квалифицировать в качестве своей простой электронной подписи под настоящим Согласием и под Политикой обработки персональных данных выполнение мною следующего действия на сайте: https://journals.rcsi.science/ нажатие мною на интерфейсе с текстом: «Сайт использует сервис «Яндекс.Метрика» (который использует файлы «cookie») на элемент с текстом «Принять и продолжить».