Shehzad T, Dar N R, Zakria M
Department of Dermatology, Naval Hospital PNS Shifa, Karachi.
J Pak Med Assoc. 2004 Sep;54(9):453-5.
To document the efficacy of concomitant use of PUVA and methotrexate in disease clearance time in plaque type psoriasis.
Sixty male patients between 18 to 50 years of age suffering from plaque type of psoriasis with PASI score more than 10 were enrolled in the study between March 2001 to November 2001. They were divided into three groups of 20 patients each. Group A received only PUVA, Group B received only Methotrexate and group C received both PUVA and Methotrexate concomitantly. PUVA was given four times a week according to11011 schedule. The end point for clearance of psoriasis was taken as 75% reduction in PASI score from the baseline.
Group A: The minimum number of PUVA sessions needed for clearance was 20 and the maximum number was 25 (mean - 22.5). The mean clearance time was 5.5 weeks. The cumulative dose of UVA radiation ranged from 150-250 J/cm2 (mean -200 J/cm2). Group B: The time required for clearance was 7 weeks at the minimum and 9 weeks at the maximum (mean - 8 weeks). Group C: The minimum number of PUVA sessions needed for clearance was 8 and maximum was 12 (mean 10). The mean time for clearance was 2.5 weeks. The cumulative dose of UVA radiation ranged from 56-108 J/cm2 (mean-82 J/cm2). No significant side effects were seen in the three treatment groups.
The results suggest that combination of PUVA and methotrexate is an effective and safe modality for clearance of psoriasis.
记录补骨脂素紫外线A光化学疗法（PUVA）与甲氨蝶呤联合使用对斑块型银屑病疾病清除时间的疗效。
2001年3月至2001年11月，纳入60例年龄在18至50岁之间、斑块型银屑病患者，其银屑病面积和严重程度指数（PASI）评分超过10分。他们被分为三组，每组20例患者。A组仅接受PUVA治疗，B组仅接受甲氨蝶呤治疗，C组同时接受PUVA和甲氨蝶呤治疗。PUVA按照11011方案每周进行4次。银屑病清除的终点定义为PASI评分较基线降低75%。
A组：清除所需的PUVA治疗最少次数为20次，最多为25次（平均 - 22.5次）。平均清除时间为5.5周。紫外线A辐射的累积剂量范围为150 - 250 J/cm²（平均 - 200 J/cm²）。B组：清除所需时间最短为7周，最长为9周（平均 - 8周）。C组：清除所需的PUVA治疗最少次数为8次，最多为12次（平均10次）。平均清除时间为2.5周。紫外线A辐射的累积剂量范围为56 - 108 J/cm²（平均 - 82 J/cm²）。三个治疗组均未观察到明显的副作用。
结果表明，PUVA与甲氨蝶呤联合使用是清除银屑病的一种有效且安全的方式。
