Department of Dermatology, Rohtak, Haryana, India.
Indian J Dermatol Venereol Leprol. 2010 Sep-Oct;76(5):533-7. doi: 10.4103/0378-6323.69081.
Psoralen UV-A (PUVA) is an established therapy for psoriasis, but there is a well-documenated risk of melanoma and nonmelanoma skin cancer. Narrow-band Ultraviolet-B (NBUVB) therapy has a lower carcinogenic risk, has equal therapeutic potential and is considerably safe in the long term than PUVA.
The aim of present study was to compare the efficacy and side-effects of PUVA and NBUVB in chronic plaque psoriasis.
Sixty patients of chronic plaque psoriasis were taken up for the study and were randomly divided into two groups of 30 each. They were well matched in terms of age, sex, psoriasis extent and pretreatment psoriasis area severity index (PASI) scoring. One group was treated with twice-weekly narrow-band UV-B (TL-01) phototherapy and the other group received twice-weekly oral 8-Methoxsalen PUVA for a period of 3 months.
Both the groups achieved >75% reduction in the PASI score or complete clearance at the end of 3 months, but PUVA group patients required significantly fewer number of treatment sessions and fewer number of days to clear the psoriasis as compared to the NBUVB group, while the mean cumulative clearance dose and adverse effects were significantly lower in the NBUVB group.
We concluded that PUVA group patients achieved a faster clearance, but the adverse effects were significantly lower in the NBUVB group.
补骨脂素联合长波紫外线(PUVA)是一种治疗银屑病的成熟疗法,但有充分记录的黑色素瘤和非黑色素瘤皮肤癌风险。窄谱中波紫外线(NBUVB)治疗的致癌风险较低,具有同等的治疗潜力,并且长期来看比 PUVA 安全得多。
本研究旨在比较 PUVA 和 NBUVB 在慢性斑块状银屑病中的疗效和副作用。
将 60 例慢性斑块状银屑病患者纳入研究,并随机分为两组,每组 30 例。两组在年龄、性别、银屑病程度和治疗前银屑病面积严重程度指数(PASI)评分方面均匹配良好。一组接受每周两次窄带 UV-B(TL-01)光疗,另一组接受每周两次口服 8-甲氧基补骨脂素 PUVA 治疗,为期 3 个月。
两组在 3 个月结束时均实现了 PASI 评分>75%的降低或完全清除,但与 NBUVB 组相比,PUVA 组患者需要的治疗次数和清除银屑病的天数明显更少,而 NBUVB 组的平均累积清除剂量和不良反应明显更低。
我们得出结论,PUVA 组患者的清除速度更快,但 NBUVB 组的不良反应明显更低。