Service of Dermatology, General University Hospital of Alicante, C/ Pintor Baeza, 12, ES-03010 Alicante, Spain.
Acta Derm Venereol. 2020 Mar 18;100(6):adv00089. doi: 10.2340/00015555-3453.
The aim of this prospective study in a phototherapy unit was to describe adverse events (AEs) associated with discontinuation of phototherapy in a clinical setting. A total of 872 included patients received 1,256 courses of phototherapy treatment: 76.9% narrow-band UVB (NBUVB); 9.6% systemic psoralen plus UVA (PUVA); 11.4% topical PUVA; and 2.1% UVA. Approximately a fifth of the treatments (n = 240, 19.1%) were associated with AEs, the most frequent of which was erythema (8.8%). Systemic PUVA had the highest rate of AEs (32.5%). Mycosis fungoides was the dermatosis with the highest rate of AE (36.9%). A total of 216 (17.2%) patients stopped treatment: 23.6% because of AEs (4.1% of all treatments). Treatment suspension due to AEs was associated with PUVA, both topical and systemic (p < 0.001), and diagnoses of mycosis fungoides (p <0.001), palmoplantar psoriasis (p = 0.002), hand eczema (p = 0.002) and pityriasis lichenoides (p = 0.01). In conclusion, one in every 5 patients receiving phototherapy had an AE, but few stopped treatment for this reason.
这项光疗病房的前瞻性研究旨在描述临床环境中因光疗中断而出现的不良事件 (AE)。共有 872 例患者接受了 1256 次光疗治疗:76.9%为窄谱 UVB (NBUVB);9.6%为全身补骨脂素加 UVA (PUVA);11.4%为局部 PUVA;2.1%为 UVA。大约五分之一的治疗(n=240,19.1%)与 AE 相关,最常见的是红斑(8.8%)。全身 PUVA 的 AE 发生率最高(32.5%)。蕈样肉芽肿是 AE 发生率最高的皮肤病(36.9%)。共有 216 例(17.2%)患者停止治疗:23.6%是因为 AE(占所有治疗的 4.1%)。AE 导致的治疗中止与 PUVA(包括局部和全身)以及蕈样肉芽肿(p<0.001)、掌跖银屑病(p=0.002)、手部湿疹(p=0.002)和 pityriasis lichenoides(p=0.01)有关。总之,每 5 例接受光疗的患者中就有 1 例出现 AE,但因 AE 而停止治疗的患者很少。