P31134Nle-D-7Phe-alfa-melanocyte-stimulating hormone to treat congenitalerythropoietic and hepatoerythropoietic porphyria: An open-label com-passionate use application

Juergen Harms, Stadtspital Triemli, Zurich, Switzerland; Elisabeth I. Minder,Stadtspital Triemli, Zurich, Switzerland

Congenital erythropoietic porphyria (CEP) and hepatoerythropoietic porphyria(HEP), the very rare forms of recessive porphyrias, are photomutilating diseasescaused by excessive production of light sensitizing porphyrins in bone marrow andtheir accumulation in the dermis. Bone marrow transplantation is curative, ofsignificant risk, requiring a suitable bone marrow donor, and expensive. 4Nle-D-7Phe-alfa-melanocyte-stimulating hormone (NDP-MSH), an alfaeMSH analog onehundred times more active than the native hormone, induces melanin synthesis andskin tanning. Further, it reduces light penetrability of skin and light-inducedepidermal cell damage, such as excess H2O2 production or DNA dipyrimidineformation. Based on beneficial effects in our recent open-label phase II pilot studyapplying CUV1647, a slow-release formulation of NDP-MSH, to erythropoieticporphyria patients, we hypothesized that porphyria-related skin symptoms of CEPor HEP may be reduced by treatment with NDP-MSH.

Methods: After written informed consent was provided, a 58-year-old CEP patientwith extensive photo mutilation of the face and hands was treated with 20 or 16 mgof CUV1647 since April 2007 every 60 days. Two additional patients with CEP andHEP will be started on CUV1647 treatment by early summer 2008. Skin pain will bemeasured daily on a visual analog scale. Quality of life will be assessed bimonthly bythe Wales dermatologic life quality questionnaire. Laboratory safety examinationswill be performed and spontaneous reactions of the patients on changes induced bytreatment will be collected.

Results: The CEP patient treated since April 2007 reported a progressive decrease ofpain scores and an increase in life quality. He stated that the formation of new skinblisters was less than in other years and that his otherwise tense and painful skin ofcheeks and the neck became softer than before. The experience of the other twopatients beginning the therapy in near future will also be presented.

MARCH 2

cial support: The study drug was sponsored by Clinuvel Pharmac

Commer euticalsLtd.

P3114Sunburn protection by sun protection factor (SPF) 85 and SPF 50sunscreens at high altitudes

Darrell S. Rigel, MD, NYU Medical Center, New York, NY, United States; TheresaChen, PhD, Neutrogena Corporation, Los Angeles, CA, United States; YohiniAppa, PhD, Neutrogena Corporation, Los Angeles, CA, United States

The number and intensity of sunburns have been shown to correlate with thedevelopment of melanoma and other skin cancers in many studies. Some of the mostextreme ultraviolet conditions occur during the time of high altitudeerelatedexposure. Ultraviolet intensities in winter months at these altitudes and conditionssignificantly exceed ultraviolet levels measured at (midsummer) noon at sea level forsimilar latitudes. This study was aimed at evaluating whether a difference existsbetween the protective effects of a sun protection factor (SPF) 50 sunscreen versusan SPF 85 sunscreen under the extreme sun exposure conditions at high altitudes.The in vivo evaluation was conducted with a double-blind, randomized, split-facedesign on 58 subjects with Fitzpatrick skin phototypes I to IV who applied thesunscreens, one to the right and one to the left side of the face according to therandomization table, before a whole day of skiing or snowboarding in January at Vail,CO (elevation, 8500 ft). Ultraviolet B (UVB) and UVA irradiation from the sun weremeasured with a radiometer at 1-hour intervals. Participants applied the sunscreensin the morning before skiing and returned on the next morning for skin evaluationby a dermatologist, photography, and self-assessment via questionnaire. Statisticalanalysis was performed for differences of sunburn protection between the twoproducts. Subjects reported an average of 5 hours outdoors skiing or snowboarding.Dermatologist grading of erythema showed eight persons with clinically noteddifferences (from baseline) by side; of which seven were on the SPF 50sunscreenetreated side and one on the SPF 85 sunscreenetreated side (P \ .05;x2). Subject self-assessment revealed that 29 subjects preferred the SPF 85 sunscreenside, six subjects preferred the SPF 50 sunscreen, and 21 subjects had no preference(P\.001; x2). Subjects also reported that they were less likely to feel sunburned orwind burned and felt less irritated and more moisturized with the SPF 85 sunscreenthan the SPF 50 sunscreen. These results demonstrate that the SPF 85 sunscreenclinically outperformed and was preferred by the study subjects over the SPF 50sunscreen when evaluated under extreme sun exposure at high altitudes.

cial support: 100% sponsored by Neutrogena Corporation.

Commer

009

P3115Effect of intense pulsed light therapy on the skin immune system

Marta Boros-Gyevi, Department of Dermatology, University of Szeged, Szeged,Hungary; Erika Varga, MD, Department of Dermatology, University of Szeged,Szeged, Hungary; Lajos Kemeny, MD, PhD, Department of Dermatology,University of Szeged, Szeged, Hungary; Marta Morvay, MD, Department ofDermatology, University of Szeged, Szeged, Hungary

Chronic photodamage has long-term consequences corresponding to photoagingand carcinogenesis. Intense pulsed light (IPL) is a noncoherent, filtered flashlamp,emitting a broadband visible light. It has been successfully used in the treatment ofphotodamaged facial skin, promoting the production of collagen and remodelingelastic fibers. However, there is no data about the effect of IPL on the skin’s immunesystem. The aim of the study was to investigate whether IPL therapy influences thedelayed type hypersensitivity (DTH) reaction in photodamaged skin and to evaluatethe differences in DTH reactions in chronically sun-exposed and normal skin.Twelve patients (8 female, 4 male; mean age, 60 yrs) with sun-damaged skin wereinvolved in our study. Mantoux test representing DTH reaction was performed ineach patient on the internal (relatively sun-protected) and external (sun-exposed)surface of the upper arm. All volunteers received three consecutive sessions of IPLphotorejuvenation at 3-week intervals on sun-exposed skin. Mantoux tests wererepeated on the treated sites after the irradiation and compared with those of beforetreatment. Punch biopsies were taken from normal and sun-damaged skin beforeand after IPL treatment. Langerhans cells (LCs) as the major antigen presenting cellsof the skin were detected with CD1a staining. The number of CD1a1 Langerhanscells was compared in normal and sun-exposed skin before and after treatment. Wefound that DTH reaction was significantly lower on sun-exposed skin compared tonormal skin. IPL therapy improved photodamaged skin texture and there was atendency in DTH reaction to be higher after IPL treatment. The number of LCs alsotended to be higher after the photorejuvenation. These results suggest that IPLtherapy also affects the immunologic functions of the skin.

cial support: None identified.

Commer

P3116A comparison of the ultraviolet light output of residential compactfluorescent lamps to that of incandescent and halogen light bulbs

Andra Nuzum-Keim, MD, University of Oklahoma Health Sciences Center,Oklahoma City, OK, United States; Andrea Musel, MD, University of OklahomaHealth Sciences Center, Oklahoma City, OK, United States; Richard D.Sontheimer, MD, University of Oklahoma Health Sciences Center, OklahomaCity, OK, United States

Many dermatologic and some systemic conditions (eg, systemic lupus erythemato-sus) involve a component of ultraviolet light (UVL) sensitivity. Photosensitivepatients often inquire about the UVL output of light sources in their homes, and areespecially curious about whether switching to energy-efficient compact fluorescentlamps (CFLs) may adversely affect their skin disease. We therefore measured the UVAand UVB output of several randomly purchased commercial brands of equivalentwattage CFL, incandescent light bulbs, and halogen light bulbs at several differentdistances from the light sources. UVB and UVA output was measured with an IL1700research radiometer equipped with UVB and UVA detectors (International LightTechnologies; Peabody, MA). Our objective was to quantify the comparative levels ofUVB and UVA leak between these different types of residential light sources. We alsowanted to determine if there was a ‘‘safe’’ distance from these light sources whereessentially no UVL would reach the skin. Interestingly, we found that UVA leak washighest from incandescent and halogen bulbs while UVB leak was highest from CFL.The overall lowest combined UVA/UVB leak was from shielded CFL.

cial support: None identified.

Commer

J AM ACAD DERMATOL AB155