Yoshiike T, Sindhvananda J, Aikawa Y, Nakajima S, Ogawa H
Department of Dermatology, Juntendo University School of Medicine, Tokyo, Japan.
J Dermatol. 1991 Apr;18(4):201-5. doi: 10.1111/j.1346-8138.1991.tb03068.x.
Forty-seven adolescent and adult patients suffering from long-standing atopic dermatitis (AD) too severe to respond to conventional therapies were treated with topical psoralen photochemotherapy (PUVA) and relatively low doses of ultraviolet (UV) irradiation. For practicality and convenience, two different therapeutic regimens were implemented; short-term hospitalization with almost daily irradiation (inpatient group, n = 23) and weekly irradiation combined with topical corticosteroids which had failed to manage symptoms before initiating the treatment (outpatient group, n = 25). Excellent therapeutic effects were achieved in 72% of the inpatients after 5-38 (mean 18.2) times of irradiation (mean cumulative dose; 44.7 J/cm2). In addition, 56% of outpatients responded excellently to the treatment after 6-22 (mean 13.0) times (mean cumulative dose; 25.8 J/cm2). In fact, 16 of the inpatients and 10 of the outpatients achieved almost complete remission. The duration of remission in these patients was 1-25 months (mean 6.3 months) in the inpatients and 1-6 months (mean 3.0 months) in the outpatients. Peripheral blood eosinophils significantly decreased after the treatments. A follow-up study showed a delayed decrease in serum IgE levels. In contrast, the specific IgE to house dust antigens and the water holding capacity of stratum corneum did not vary after treatment.
47名患有长期特应性皮炎（AD）且病情严重到对传统疗法无反应的青少年和成年患者接受了外用补骨脂素光化学疗法（PUVA）和相对低剂量的紫外线（UV）照射治疗。为了实用和方便，实施了两种不同的治疗方案；短期住院并几乎每日照射（住院组，n = 23）以及每周照射并联合在治疗开始前未能控制症状的外用糖皮质激素（门诊组，n = 25）。住院患者在照射5 - 38次（平均18.2次）后（平均累积剂量；44.7 J/cm²），72%取得了优异的治疗效果。此外，门诊患者在照射6 - 22次（平均13.0次）后（平均累积剂量；25.8 J/cm²），56%对治疗反应优异。实际上，16名住院患者和10名门诊患者几乎完全缓解。这些患者的缓解期在住院患者中为1 - 25个月（平均6.3个月），在门诊患者中为1 - 6个月（平均3.0个月）。治疗后外周血嗜酸性粒细胞显著减少。一项随访研究显示血清IgE水平延迟下降。相比之下，治疗后针对屋尘抗原的特异性IgE和角质层的持水能力没有变化。
