Uetsu Naoko, Horio Takeshi
Department of Dermatology, Kansai Medical University, Moriguchi, Osaka, Japan.
J Dermatol. 2003 Jun;30(6):450-7. doi: 10.1111/j.1346-8138.2003.tb00415.x.
Oral administration of psoralen and whole body exposure to UVA (oral PUVA) has been used for the treatment of 113 patients with severe atopic dermatitis (AD). 8-Methoxypsoralen (8-MOP) was given at a dose of 0.5-0.6 mg/kg two hours prior to UVA (3-8 J/cm2) irradiation. Patients were treated three times a week while hospitalized. Other medications which had been given before PUVA therapy were permitted. At four and eight weeks after PUVA therapy, the severity score of AD had decreased by 51% and 80%, and the cumulative doses of UVA were 51.2 J/cm2 and 115.3 J/cm2, respectively. The amounts and strength of topical cortico-steroids were decreased during PUVA therapy. No adverse effects that required discontinuation of the PUVA therapy were observed. After discharge, maintenance therapy with UVB phototherapy and/or conventional treatment of AD kept the patients in remission in the outpatient clinic. The QOL of patients was greatly improved. Photochemotherapy with oral 8-MOP can be indicated in patients with severe, widespread AD, especially if standard therapy fails. This is the first report of oral PUVA therapy in a large series of Japanese patients with AD.
口服补骨脂素并全身暴露于长波紫外线（口服光化学疗法）已用于治疗113例重度特应性皮炎（AD）患者。在长波紫外线（3 - 8 J/cm²）照射前两小时，以0.5 - 0.6 mg/kg的剂量给予8 - 甲氧基补骨脂素（8 - MOP）。患者住院期间每周接受三次治疗。允许在光化学疗法前使用的其他药物继续使用。在光化学疗法治疗四周和八周后，特应性皮炎的严重程度评分分别下降了51%和80%，长波紫外线的累积剂量分别为51.2 J/cm²和115.3 J/cm²。在光化学疗法治疗期间，局部皮质类固醇的用量和强度有所减少。未观察到需要停止光化学疗法的不良反应。出院后，采用中波紫外线光疗和/或特应性皮炎的常规治疗进行维持治疗，使患者在门诊保持缓解状态。患者的生活质量得到了极大改善。对于重度、广泛的特应性皮炎患者，尤其是标准治疗失败时，可采用口服8 - MOP进行光化学疗法。这是关于大量日本特应性皮炎患者口服光化学疗法的首篇报道。
