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Morphea (localized scleroderma) is generally difficult to treat. Recently, ultraviolet light A-1 (UVA-1, 340 to 400 nm) has been shown to be successful. UVA-1 phototherapy may induce interstitial collagenase, or matrix metalloproteinase 1 (MMP-1), thereby clearing accumulated dermal collagen. In a study of five patients with severe morphea, investigators evaluated this hypothesis.
Patients received UVA-1 phototherapy at 20 J/cm2 once per day four times per week for six weeks. Three of the five patients cleared completely, and the other two had softening of their scleroderma. MMP-1 RNA and MMP-1 protein expression were assayed in skin biopsies before and after treatment. UVA-1 irradiation caused an increase in the expression of MMP-1 in fibro…