Das S, Lloyd J J, Walshaw D, Diffey B L, Farr P M
Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, U.K.
Br J Dermatol. 2002 Nov;147(5):966-72. doi: 10.1046/j.1365-2133.2002.04868.x.
Sunbeds fitted with conventional ultraviolet (UV) A lamps that have about 0.7% UVB emission are widely used by patients with psoriasis even though they are minimally effective. A new fluorescent sunbed lamp has been developed that emits a higher proportion of UVB (4.6%) than conventional lamps and also requires shorter exposure times to achieve equivalent erythema.
To perform a randomized, within-patient comparison of conventional sunbed lamps (Cleo Performance) with the new lamps (Cleo Natural) in the treatment of psoriasis.
A sunbed and canopy unit were modified to allow exposure to Cleo Performance lamps on one side of the body (front and back) and Cleo Natural lamps to the other side of the body. Two studies were done. In study 1, equal erythemal doses were given from the two lamp types. In study 2, equal exposure times were given. We treated 34 patients with psoriasis, giving 12 exposures over a period of 4 weeks. Assessment was made using a modified Psoriasis Area and Severity Index (PASI) score, individual plaque assessment and patient questionnaire.
Fourteen patients completed each study. In study 1, there was no significant difference in median improvement in half-body PASI score for the two lamp types. In study 2, there was a significant difference in PASI score improvement between the two lamps (median Cleo Performance change minus median Cleo Natural change was - 2.20; 95% confidence interval - 3.75 to - 0.65; P = 0.006).
That no difference in response was found when equal erythemal doses were given suggests that the spectral emission of the Cleo Natural lamp is of no greater advantage for clearance of psoriasis than conventional lamps. However, the Cleo Natural lamps are more erythemally powerful, and exposure times similar to those used in conventional sunbeds result in a significant improvement of psoriasis. The risk of non-melanoma skin cancer from different patterns of exposure to Cleo Natural lamps can be estimated using established numerical models.
配备传统紫外线（UV）A灯且紫外线B（UVB）发射率约为0.7%的日光浴床，尽管其疗效甚微，但仍被银屑病患者广泛使用。一种新型荧光日光浴床灯已被研发出来，其UVB发射比例（4.6%）高于传统灯具，且达到同等红斑效果所需的照射时间更短。
在银屑病治疗中，对传统日光浴床灯（Cleo Performance）和新型灯（Cleo Natural）进行患者内随机比较。
对一台日光浴床和天篷装置进行改装，使身体一侧（前后）暴露于Cleo Performance灯，另一侧暴露于Cleo Natural灯。进行了两项研究。在研究1中，两种灯给予相等的红斑剂量。在研究2中，给予相等的照射时间。我们对34例银屑病患者进行治疗，在4周内进行12次照射。使用改良的银屑病面积和严重程度指数（PASI）评分、单个斑块评估和患者问卷进行评估。
每项研究均有14例患者完成。在研究1中，两种灯型的半身PASI评分中位数改善情况无显著差异。在研究2中，两种灯之间的PASI评分改善存在显著差异（Cleo Performance中位数变化减去Cleo Natural中位数变化为 - 2.20；95%置信区间 - 3.75至 - 0.65；P = 0.006）。
给予相等红斑剂量时未发现反应差异，这表明Cleo Natural灯的光谱发射在清除银屑病方面并不比传统灯具有更大优势。然而，Cleo Natural灯的红斑效应更强，与传统日光浴床使用的照射时间相似会使银屑病有显著改善。使用既定的数值模型可以估计不同照射模式下接触Cleo Natural灯导致非黑素瘤皮肤癌的风险。
