Rodenbeck Dorothy L, Silverberg Jonathan I, Silverberg Nanette B
Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.
Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; Northwestern Medicine Multidisciplinary Eczema Center, Chicago, IL.
Clin Dermatol. 2016 Sep-Oct;34(5):607-13. doi: 10.1016/j.clindermatol.2016.05.011. Epub 2016 May 20.
Phototherapy is a second-line treatment for moderate to severe atopic dermatitis (AD) that effectively decreases cutaneous inflammation with minimal or no systemic side effects. Children in grade school, adolescents, and adults may benefit from phototherapy, when they have chronic AD refractory to first-line topical treatments. This review focuses on six approaches for phototherapy in AD: (1) broadband ultraviolet B (UVB), (2) Goeckerman regimen (coal tar + broadband UVB), (3) narrowband UVB, (4) excimer lasers for targeted areas, (5) combination UVA/UVB, and (6) UVA-1. Phototherapy can be very effective in some individuals, but it is limited by inconvenience and adverse effects, including limited access to in-office treatment, difficulty adhering to thrice-weekly schedule, flaring from excessive heat, and increased risk of skin cancer. Dosing regimen and treatment concerns are reviewed.
光疗是中度至重度特应性皮炎（AD）的二线治疗方法，可有效减轻皮肤炎症，且全身副作用极小或无副作用。小学儿童、青少年和成人若患有对一线局部治疗无效的慢性AD，可能会从光疗中获益。本综述重点介绍AD光疗的六种方法：（1）宽带紫外线B（UVB），（2）格克曼疗法（煤焦油 + 宽带UVB），（3）窄带UVB，（4）针对特定部位的准分子激光，（5）UVA/UVB联合疗法，以及（6）UVA-1。光疗对某些个体可能非常有效，但受到不便和不良反应的限制，包括门诊治疗机会有限、难以坚持每周三次的治疗计划、因过热导致病情加重以及皮肤癌风险增加。本文对给药方案和治疗注意事项进行了综述。
