a Dermatology Department, Faculty of Medicine, Cairo University , Cairo , Egypt.
b Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University , Cairo , Egypt.
J Dermatolog Treat. 2019 Sep;30(6):582-587. doi: 10.1080/09546634.2018.1543847. Epub 2019 Jan 8.
Various therapeutic agents have been described for alopecia areata but none is satisfactory. The use of ultraviolet A phototherapy in phototoxic regimens has emerged lately with promising results. To determine the efficacy and safety of phototoxic regimen of psoralen ultraviolet A (PUVA) in comparison to conventional therapy with intralesional corticosteroids in patients with alopecia areata. In this randomized controlled clinical trial, 40 patients were randomized to either phototoxic regimen of psoralen ultraviolet A group or potent intralesional corticosteroids group for three months. Study ended at six months. The primary outcome was treatment success: sustained regrowth of hair in ≥80% of the affected areas at six months. Tissue cytokines were assessed at zero and three months. At six months, treatment success was achieved by 45% of patients, similarly in both groups. Tissue cytokine expression correlated well with clinical response. Phototoxic regimen of topical PUVA deserves a place among therapeutic tools used in management of alopecia areata especially in more extensive conditions where intralesional corticosteroids would not be suitable. https://clinicaltrials.gov/ct2/show/record/NCT01559584.
各种治疗药物已被描述用于治疗斑秃，但没有一种是令人满意的。最近，光毒疗法在光毒性方案中的应用已经出现，并取得了有希望的结果。为了确定光毒疗法（PUVA）与传统皮损内皮质类固醇治疗斑秃患者的疗效和安全性。在这项随机对照临床试验中，40 名患者被随机分为光毒疗法组或强效皮损内皮质类固醇组，治疗时间为三个月。研究在六个月时结束。主要终点是治疗成功：六个月时，≥80%受影响区域的头发持续再生。在零个月和三个月时评估组织细胞因子。在六个月时，两组患者的治疗成功率均为 45%。组织细胞因子表达与临床反应密切相关。局部 PUVA 的光毒疗法应在斑秃的治疗工具中占有一席之地，特别是在更广泛的情况下，皮损内皮质类固醇不适用。https://clinicaltrials.gov/ct2/show/record/NCT01559584。
