Macias Vasco Coelho, Marques-Pinto Gabriela, Cardoso Jorge
Hospital de Curry Cabral, Dermatology and Venereology Department, Lisbon, Portugal.
Cutan Ocul Toxicol. 2013 Jun;32(2):124-7. doi: 10.3109/15569527.2012.717572. Epub 2012 Sep 13.
Pityriasis lichenoides is a benign disease that includes a continuous spectrum with two polar ends: pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis lichenoides chronica (PLC). Although its benign and self-limited character, treatment is required, both for itch relief and for cosmetic issues. The present study is a retrospective analysis of 13 patients (11 PLC and 2 PLEVA) treated in our institution with psoralen plus ultraviolet A (PUVA) or ultraviolet A combined with ultraviolet B (UVA/UVB) during the period 1998-2011. In the PUVA group, complete response was achieved in five patients and partial response in two. Total cumulative UVA dose was 84.4 J/cm(2). One patient quit therapy without therapeutic response. In the UVA/UVB group, complete response was achieved in two patients and partial response in an equal number of patients. One patient did not reach a significant improvement. Total cumulative doses were: 26.1 J/cm(2) for UVA and 3.62 J/cm(2) for UVB. There were no acute side effects in either therapeutic group. In the present study, PUVA phototherapy was preferred for patients with more widespread or long-evolving disease, while UVA/UVB was selected for patients who presented more recent disease or contraindications for PUVA therapy. Regardless of the absence of clinical guidelines, both therapeutic options proved to be successful, ascertaining phototherapy as an effective and safe option for pityriasis lichenoides patients.
苔藓样糠疹是一种良性疾病,其包括一个具有两个极端的连续谱:急性痘疮样苔藓样糠疹(PLEVA)和慢性苔藓样糠疹(PLC)。尽管其具有良性和自限性,但仍需要治疗,以缓解瘙痒和解决美观问题。本研究是对1998年至2011年期间在我们机构接受补骨脂素加紫外线A(PUVA)或紫外线A联合紫外线B(UVA/UVB)治疗的13例患者(11例PLC和2例PLEVA)的回顾性分析。在PUVA组中,5例患者获得完全缓解,2例患者获得部分缓解。UVA的总累积剂量为84.4 J/cm²。1例患者未出现治疗反应即停止治疗。在UVA/UVB组中,2例患者获得完全缓解,同样数量的患者获得部分缓解。1例患者未取得显著改善。总累积剂量分别为:UVA 26.1 J/cm²,UVB 3.62 J/cm²。两个治疗组均未出现急性副作用。在本研究中,PUVA光疗更适合于病情更广泛或病程更长的患者,而UVA/UVB则用于病情较新或有PUVA治疗禁忌证的患者。尽管缺乏临床指南,但这两种治疗选择均被证明是成功的,确定了光疗是苔藓样糠疹患者的一种有效且安全的选择。