Dong Da-Ke, Pan Zhan-Yan, Zhang Juan, Lu Xue-Fen, Jin Cheng, Tao Shi-Qin, Yang Li-Jia
Department of Dermatology, Wuxi Second Affiliated Hospital of Nanjing Medical University, Wuxi, Jiangsu, China.
Department of Dermatology, Ren ji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China.
Pediatr Dermatol. 2017 May;34(3):266-270. doi: 10.1111/pde.13098. Epub 2017 Mar 20.
BACKGROUND/OBJECTIVES: Phototherapy is a commonly used treatment for vitiligo that has demonstrated safety and efficacy. High-intensity targeted ultraviolet B (UVB) light (304-312 nm) delivered using a phototherapy device is a useful therapeutic option because it can induce repigmentation in a short time without global exposure to radiation, but information regarding this device in children is limited.
We performed a retrospective analysis of 95 patches of vitiligo in 27 children treated using a targeted phototherapy device. Phototherapy was administered twice a week.
After the first 10 treatment sessions, 82 (86.3%) patches demonstrated some repigmentation and 36.8% achieved 50% or more repigmentation. After a mean of 20.4 treatment sessions, 86 patches (90%) demonstrated some repigmentation and 53.7% achieved 50% or more repigmentation. Responses varied depending on the anatomic location of the lesions. Better responses were usually observed on the face and trunk, whereas the extremities typically showed little response. Repigmentation was better in patients with active vitiligo than in those with stable vitiligo, with responses better with a disease duration of 1 year or less than in those with a duration of more than 1 year. There was no statistically significant difference in repigmentation between those with segmental and generalized vitiligo. The only short-term local side effect was mild erythema that required a decrease in dosage in six patients.
Targeted high-intensity medium-band UVB phototherapy alone can produce clinical improvement in pediatric vitiligo and is well tolerated.
背景/目的：光疗是治疗白癜风的常用方法，已证明其安全性和有效性。使用光疗设备发出的高强度靶向紫外线B（UVB）光（304 - 312nm）是一种有用的治疗选择，因为它可以在短时间内诱导色素再生，而无需全身暴露于辐射，但关于该设备在儿童中的信息有限。
我们对27名使用靶向光疗设备治疗的儿童的95处白癜风皮损进行了回顾性分析。光疗每周进行两次。
在前10次治疗后，82处（86.3%）皮损出现了一些色素再生，36.8%的皮损色素再生达到或超过50%。平均20.4次治疗后，86处（90%）皮损出现了一些色素再生，53.7%的皮损色素再生达到或超过50%。疗效因皮损的解剖位置而异。通常在面部和躯干观察到更好的疗效，而四肢的反应通常较小。活动期白癜风患者的色素再生情况优于稳定期患者，病程1年或更短的患者比病程超过1年的患者反应更好。节段型和泛发型白癜风患者在色素再生方面无统计学显著差异。唯一的短期局部副作用是轻度红斑，6名患者需要减少剂量。
单独使用靶向高强度中波UVB光疗可使儿童白癜风获得临床改善，且耐受性良好。
