Department of Dermatology and Allergology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of Technical University of Dresden, Dresden, Germany.
Skin Res Technol. 2012 May;18(2):212-8. doi: 10.1111/j.1600-0846.2011.00556.x. Epub 2011 Sep 4.
Phototherapy is a cornerstone in treatment of moderate-to-severe psoriasis. Narrow-band UVB has been shown to be a potent therapeutic tool. To reduce the potential carcinogenic risk, targeted phototherapy has been developed using excimer lasers or excimer light devices (ELD).
The role of excimer light therapy in practice and modes of action are not completely understood. We wanted to investigate a 307 nm ELD for plaque psoriasis in comparison with topical dithranol therapy twice daily.
We conducted a pilot trial in 21 adult patients with moderate plaque-type psoriasis. Two target lesions of comparable size and plaque-modified Psoriasis Activity and Severity Index (PSI) scores were selected. Lesion A was treated three times using a newly developed 307 nm ELD. Lesion B was treated twice daily with dithranol ointment. The mean period of treatment was 9 days. Clinical evaluation included PSI scores, safety, time needed to treat, and patient's satisfaction. In addition, fluorescence-remission imaging technique was used for objective evaluation.
Both treatments improved the PSI score (mean 3.0 points). The treatments were safe but ELD was more convenient for patients. The time needed to treat the target lesion was significantly shorter with ELD. Targeted UVB therapy normalized NADH fluorescence in lesional skin.
The 307 nm excimer light therapy for plaque type psoriasis was equipotent to twice daily topical dithranol. Efficacy, safety, and convenience suggest that targeted UVB therapy with quasi monochromatic light is a new useful treatment option for patients with limited psoriatic plaques.
光疗是中重度银屑病治疗的基石。窄谱 UVB 已被证明是一种有效的治疗工具。为了降低潜在的致癌风险，已经开发了使用准分子激光或准分子光设备（ELD）的靶向光疗。
准分子光疗法在实践中的作用和作用机制尚不完全清楚。我们想研究一种 307nm 的 ELD 在斑块型银屑病中的应用，并与每天两次局部应用蒽林进行比较。
我们在 21 例中度斑块型银屑病成人患者中进行了一项初步试验。选择两个大小相当且斑块改良后的银屑病活动和严重程度指数（PSI）评分相同的靶病变。病变 A 用新开发的 307nm ELD 治疗三次。病变 B 每天用蒽林软膏治疗两次。平均治疗期为 9 天。临床评估包括 PSI 评分、安全性、治疗所需时间和患者满意度。此外，还使用荧光消退成像技术进行客观评估。
两种治疗方法均改善了 PSI 评分（平均 3.0 分）。治疗安全，但 ELD 对患者更方便。用 ELD 治疗靶病变所需的时间明显更短。靶向 UVB 治疗使病变皮肤中的 NADH 荧光正常化。
307nm 准分子光治疗斑块型银屑病与每天两次局部应用蒽林疗效相当。疗效、安全性和便利性表明，准分子单色光靶向治疗是一种治疗局限性银屑病斑块的新的有效治疗选择。
