Mysore Venkataram, Shashikumar B M
Department of Dermatology, Venkat Charmalaya - Centre for Advanced Dermatology, Bengaluru, Karnataka, India.
Indian J Dermatol Venereol Leprol. 2016 Jan-Feb;82(1):1-6. doi: 10.4103/0378-6323.172902.
Targeted phototherapy is a new form of phototherapy which has many advantages and disadvantages over conventional phototherapy. This article reviews the different technologies and outlines recommendations based on current evidence.
A literature search was performed on targeted phototherapy to collect data. Relevant literature published till March 2014 was obtained from PubMed, EMBASE, and the Cochrane Library. Keywords like "targeted phototherapy", "excimer laser", "excimer lamp", "Nonchromatic ultraviolet light", "vitiligo", and "psoriasis", were used for literature search. All systematic reviews, meta-analysis, national guidelines, randomized controlled trials (RCT), prospective open label studies and retrospective case series in English were reviewed.
Three hundred and forty studies were evaluated, 24 of which fulfilled the criteria for inclusion in the guidelines.
All forms of targeted phototherapy are useful in vitiligo. Good responses were seen in localized involvement, resistant lesions and in children in whom their use is more accepted and convenient (Level of evidence 2+, Grade of recommendation B). Similarly it is useful in psoriasis, either alone or in combination with drugs, even in resistant forms such as palmoplantar psoriasis. In view of expense and practical application, their use is limited to resistant lesions and localized disease. (Level of evidence 2+, Grade of recommendation B). But in other conditions there is no convincing evidence for its use. (Level of evidence 3+, Grade of recommendation C).
靶向光疗是一种新型光疗方式，与传统光疗相比有诸多优缺点。本文综述了不同技术，并根据现有证据给出建议。
对靶向光疗进行文献检索以收集数据。从PubMed、EMBASE和Cochrane图书馆获取截至2014年3月发表的相关文献。使用“靶向光疗”“准分子激光”“准分子灯”“非色紫外光”“白癜风”和“银屑病”等关键词进行文献检索。对所有英文的系统评价、荟萃分析、国家指南、随机对照试验（RCT）、前瞻性开放标签研究和回顾性病例系列进行了综述。
共评估了340项研究，其中24项符合纳入指南的标准。
所有形式的靶向光疗对白癜风均有效。在局限性病变、难治性皮损以及儿童患者中疗效良好，在儿童中使用更易被接受且方便（证据级别2+，推荐等级B）。同样，靶向光疗对银屑病也有效，可单独使用或与药物联合使用，即使是掌跖部银屑病等难治性类型。鉴于费用和实际应用情况，其应用仅限于难治性皮损和局限性疾病（证据级别2+推荐等级B）。但在其他疾病中，尚无令人信服的证据支持其使用（证据级别3+，推荐等级C）。
