Lamba S, Lebwohl M
Department of Dermatology, Mount Sinai Medical Center, New York 10029-6574, USA.
Br J Dermatol. 2001 Apr;144 Suppl 58:27-32. doi: 10.1046/j.1365-2133.2001.144s58027.x.
Monotherapy with vitamin D analogues has been shown to be effective in the treatment of psoriasis. Vitamin D analogues have also been used in combination with other topical therapies, systemic therapies and phototherapy. In many instances, the efficacy of these other treatments can be maximized and adverse effects minimized when combined with vitamin D analogues. The combination of a topical corticosteroid with a vitamin D analogue can work synergistically to improve efficacy and reduce the side-effects from both treatments. However, caution must be used when mixing the two agents, as some topical corticosteroids will result in the degradation of the vitamin D analogue. Benefit from phototherapy is also increased when using vitamin D analogues, so that greater improvement occurs with fewer treatments. Effects on minimal erythema dose must be considered and the potential for ultraviolet blocking by vitamin D analogues may affect treatment. Some vitamin D analogues may also be susceptible to degradation by certain wavelengths of ultraviolet light. Combining vitamin D analogues with systemic agents exerts a dose-sparing effect, thus reducing the possibility of side-effects, but such combinations require further study. As long as treatments are used correctly, the benefits of combination therapy with vitamin D analogues usually outweigh the few drawbacks.
维生素D类似物单药治疗已被证明对银屑病治疗有效。维生素D类似物也已与其他局部治疗、全身治疗及光疗联合使用。在许多情况下，这些其他治疗方法与维生素D类似物联合使用时，疗效可最大化，不良反应可最小化。局部用皮质类固醇与维生素D类似物联合使用可产生协同作用，提高疗效并减少两种治疗的副作用。然而，混合这两种药物时必须谨慎，因为一些局部用皮质类固醇会导致维生素D类似物降解。使用维生素D类似物时，光疗的益处也会增加，因此治疗次数减少时改善更明显。必须考虑对最小红斑量的影响，维生素D类似物的紫外线阻断潜力可能会影响治疗。一些维生素D类似物也可能易被某些波长的紫外线降解。维生素D类似物与全身用药联合使用可产生剂量节省效应，从而降低副作用的可能性，但此类联合用药需要进一步研究。只要正确使用治疗方法，维生素D类似物联合治疗通常利大于弊。
