Amornpinyokeit Noppadol, Asawanonda Pravit
Division of Dermatology, Department of Medicine, Chulalongkorn University, Bangkok, Thailand.
Photodermatol Photoimmunol Photomed. 2006 Dec;22(6):285-9. doi: 10.1111/j.1600-0781.2006.00249.x.
Targeted ultraviolet (UV) phototherapy is a recent addition to the therapeutic armamentarium for the treatment of localized psoriasis. Topical psoralens enhance the therapeutic effects of UV-based treatment for various dermatoses, but have never been used in conjunction with targeted UVB.
To compare the efficacy of targeted narrowband UVB phototherapy (NB-UVB) alone with that of the combination of 0.1% 8-methoxypsoralen cream and targeted NB-UVB phototherapy (8-MOP/NB-UVB) for the treatment of plaque-type psoriasis.
Two areas within the same lesion of stable psoriasis were randomized to receive either targeted NB-UVB alone or 8-MOP/NB-UVB. Fluences of UVB delivered were held constant at four minimal erythema doses. The treatments were continued until lesions cleared or 12 treatments. Follow-ups were done until lesional scores returned to 50% of the baseline values.
Ten patients completed this study. Four lesions were cleared by 8-MOP/NB-UVB while three were cleared by NB-UVB alone. The improvement in disease activity as reflected by psoriasis severity index score during treatment was statistically significantly better in the combination group (P=0.005). Mean remission time of lesions which were cleared by 8-MOP/NB-UVB was 8 weeks while that for lesions that were cleared by NB-UVB alone was 4.67 weeks.
We concluded that addition of 0.1% 8-MOP cream to targeted narrowband UVB significantly enhances the therapeutic effects of the light treatment without increasing the incidence of adverse effects.
靶向紫外线(UV)光疗是治疗局限性银屑病的最新治疗手段。外用补骨脂素可增强基于紫外线的治疗对各种皮肤病的疗效,但从未与靶向窄谱中波紫外线(NB-UVB)联合使用过。
比较单独使用靶向窄谱中波紫外线(NB-UVB)光疗与联合使用0.1% 8-甲氧基补骨脂素乳膏和靶向NB-UVB光疗(8-MOP/NB-UVB)治疗斑块型银屑病的疗效。
将同一稳定期银屑病皮损内的两个区域随机分为单独接受靶向NB-UVB或8-MOP/NB-UVB治疗。紫外线B的照射剂量保持在四个最小红斑量不变。治疗持续至皮损清除或进行12次治疗。随访至皮损评分恢复至基线值的50%。
10例患者完成本研究。8-MOP/NB-UVB清除了4处皮损,而单独使用NB-UVB清除了3处皮损。联合治疗组治疗期间银屑病严重程度指数评分所反映的疾病活动改善情况在统计学上显著更好(P=0.005)。8-MOP/NB-UVB清除的皮损平均缓解时间为8周,而单独使用NB-UVB清除的皮损平均缓解时间为4.67周。
我们得出结论,在靶向窄谱中波紫外线中添加0.1% 8-MOP乳膏可显著增强光疗的疗效,且不增加不良反应的发生率。