Schiener Ralf, Brockow Thomas, Franke Annegret, Salzer Bernd, Peter Ralf U, Resch Karl L
Department of Dermatology, University of Ulm, Germany.
Arch Dermatol. 2007 May;143(5):586-96. doi: 10.1001/archderm.143.5.586.
To evaluate the efficacy of psoralens dissolved in a warm-water bath followed by exposure to UV-A irradiation (bath PUVA) or saltwater phototherapy (SW UV-B) compared with tap-water phototherapy (TW UV-B) or UV-B irradiation alone in psoriasis.
Multisite, prospective, randomized, controlled trial with 4 parallel groups.
Total of 102 dermatologic outpatient clinics.
Total of 1241 patients with stable psoriasis vulgaris and a Psoriasis Area and Severity Index score of 7 or greater.
Four-times-weekly UV-B, TW UV-B, SW UV-B, or bath-PUVA with baths preceding UV irradiation over a maximum of 8 weeks. The UV dose was adapted to erythemal response.
Incidence of therapeutic success, defined as a reduction of the Psoriasis Area and Severity Index or affected body surface area of 50% or more.
Patients who received TW UV-B had a significantly higher incidence of therapeutic success than did patients treated with UV-B alone (60.7% vs 43.3%; P<.001; number needed to treat, 5.8; 95% confidence interval [CI], 3.9-10.9). Patients who received SW UV-B or bath PUVA had a significantly higher incidence of therapeutic success than did patients treated with TW UV-B (74.9% vs 60.7%; P<.001; number needed to treat, 7.0; 95% CI, 4.6-14.9; and 78.4% vs 60.7%; P<.001; number needed to treat, 5.7; 95% CI, 4.0-9.7, respectively). Bath PUVA was not superior to SW UV-B (78.4% vs 74.9%; P = .34).
Bath PUVA and SW UV-B are comparably effective treatments in psoriasis and superior to UV-B and TW UV-B.
评估补骨脂素溶于温水浴后接受紫外线A照射（水浴光化学疗法）或盐水光疗与单独使用自来水光疗或紫外线B照射相比，治疗银屑病的疗效。
多中心、前瞻性、随机对照试验，分为4个平行组。
共102家皮肤科门诊诊所。
共1241例寻常型银屑病稳定期患者，银屑病面积和严重程度指数评分≥7分。
每周进行4次紫外线B、自来水光疗、盐水光疗或水浴光化学疗法，紫外线照射前进行沐浴，最长持续8周。紫外线剂量根据红斑反应进行调整。
治疗成功的发生率，定义为银屑病面积和严重程度指数或受累体表面积减少50%及以上。
接受自来水光疗的患者治疗成功的发生率显著高于单独接受紫外线B治疗的患者（60.7%对43.3%；P<0.001；需治疗人数为5.8；95%置信区间[CI]，3.9 - 10.9）。接受盐水光疗或水浴光化学疗法的患者治疗成功的发生率显著高于接受自来水光疗的患者（74.9%对60.7%；P<0.001；需治疗人数为7.0；95% CI，4.6 - 14.9；以及78.4%对60.7%；P<0.001；需治疗人数为5.7；95% CI，4.0 - 9.7）。水浴光化学疗法并不优于盐水光疗（78.4%对74.9%；P = 0.34）。
水浴光化学疗法和盐水光疗在治疗银屑病方面疗效相当，且优于紫外线B和自来水光疗。
