Department of Dermatology, Uludag University, Faculty of Medicine, Bursa, Turkey.
Int J Dermatol. 2012 Jan;51(1):98-103. doi: 10.1111/j.1365-4632.2011.05056.x.
Chronic ordinary urticaria (COU) can severely reduce quality of life and be difficult to control. Ultraviolet (UV) A and UVB phototherapy has been reported to decrease the release of histamine from either mast cells and/or basophils. Previous small studies have suggested that UVB phototherapy is a good alternative treatment for COU.
The purpose of this study was to assess the efficacy of narrow-band UVB (NB-UVB) phototherapy for COU.
Twenty-two patients (three male, 19 female) received NB-UVB phototherapy. These patients had not responded to at least two H1 antihistamines, and most had been treated with a variety of antihistamine combinations. Clinical responses were assessed according to an outcome scoring scale. During both visits, patients were administered the following: the visual analogue scale (VAS) on present pruritus and/or whealing; chronic urticaria impact on patients' quality of life according to the interference with daily activities, quality of sleep, and flare-up rates.
The median number of treatments was 31.4 (9-44), and the mean top dose was 9.46 J/cm(2) (1.1-16.4 J/cm(2)). NB-UVB treatment led to clearance in 10 patients (45%), marked improvement in five (22%), and moderate improvement in seven (31%) patients according to an outcome scoring scale. Mild side effects were observed in two patients. Six patients who cleared or observed marked improvement remained clear at follow-up for a period of six months to one year, and other patients had a few recurrent lesions that did not need retreatment. For VAS scores and total chronic urticaria impact on patients' quality of life scores, the differences between baseline and after treatment scores were significantly lower (P < 0.001, P < 0.001, respectively).
Narrow-band UVB (NB-UVB) therapy is an effective, well-tolerated treatment option in second-line therapy for COU. This therapy can lead to subjective relief of pruritus and whealing and objective reduction of whealing. Further larger studies with longer follow-up periods are necessary to determine the proper clinical response and long-term complications of this therapy in COU.
慢性特发性荨麻疹（COU）可严重降低生活质量，且难以控制。已有报道称，紫外线（UV）A 和 UVB 光疗可减少肥大细胞和/或嗜碱性粒细胞释放组胺。此前的小型研究表明，UVB 光疗是治疗 COU 的一种较好的替代治疗方法。
本研究旨在评估窄谱 UVB（NB-UVB）光疗治疗 COU 的疗效。
22 例患者（3 例男性，19 例女性）接受 NB-UVB 光疗。这些患者至少对两种 H1 抗组胺药无反应，且大多数曾接受过各种抗组胺药联合治疗。临床反应根据疗效评分量表进行评估。在两次就诊时，患者均接受以下评估：视觉模拟评分（VAS）评估当前瘙痒和/或风团；慢性荨麻疹对患者日常生活、睡眠质量和发作率的影响。
中位治疗次数为 31.4 次（9-44 次），平均最高剂量为 9.46 J/cm2（1.1-16.4 J/cm2）。根据疗效评分量表，NB-UVB 治疗后 10 例（45%）患者痊愈，5 例（22%）患者显著改善，7 例（31%）患者中度改善。2 例患者出现轻度副作用。6 例痊愈或显著改善的患者在随访 6 个月至 1 年期间仍保持无皮损，其他患者皮损偶有复发，无需再次治疗。VAS 评分和慢性荨麻疹对患者生活质量的总影响评分与治疗前相比，差异均有统计学意义（P < 0.001，P < 0.001）。
NB-UVB 疗法是 COU 二线治疗的一种有效、耐受良好的治疗选择。该疗法可缓解瘙痒和风团等主观症状，并减少风团等客观症状。还需要进一步开展更大规模、随访时间更长的研究，以确定 COU 患者接受 NB-UVB 治疗的适当临床反应和长期并发症。
