Dermatology Department, University Hospital Southampton, Southampton, UK.
University of Southampton, Southampton, UK.
Photodermatol Photoimmunol Photomed. 2021 Jan;37(1):34-38. doi: 10.1111/phpp.12604. Epub 2020 Oct 4.
BACKGROUND/PURPOSE: To examine the efficacy, tolerability and safety of phototherapy in children, in whom there is currently a paucity of data.
Retrospective review of children under 18 years who received narrowband UVB (NB-UVB), broadband UVB (BB-UVB) phototherapy or psoralen with UVA (PUVA) photochemotherapy between 2003 and 2017 at a tertiary Paediatric dermatology centre in Southampton, UK.
100 children aged 6-17 years were included. The majority of children had psoriasis (74), atopic dermatitis (10) or vitiligo (8), with others having rarer dermatoses. Grade 2 erythema or above occurred in 46% of all included children and 42% (36/86) of those receiving NB-UVB; however, grade 3 and 4 reactions were infrequent and only 3 children stopped treatment due to burning. NB-UVB was particularly effective in those with psoriasis; 55/65 (85%) significantly improved, and 72% had not relapsed after 2 years. However, its effectiveness in atopic dermatitis was less convincing; in a small group of children, 6/10 (60%) significantly improved, but 66% relapsed within 3 months.
Our analysis demonstrates that NB-UVB is effective in children with psoriasis and vitiligo, with potential to achieve extended periods of remission in psoriasis. Its usefulness in atopic dermatitis is less clear. The long-term safety of NB-UVB in children is still unknown, but it appears to be a well-tolerated treatment and should be considered in children for a variety of inflammatory dermatoses before progressing to immunosuppressive therapies.
背景/目的：目前，针对儿童窄谱 UVB（NB-UVB）、宽谱 UVB（BB-UVB）光疗或补骨脂素加 UVA（PUVA）光化学疗法的疗效、耐受性和安全性的数据十分有限，本研究旨在对此进行评估。
对 2003 年至 2017 年期间在英国南安普顿一家三级儿科皮肤科中心接受 NB-UVB、BB-UVB 光疗或 PUVA 光化学疗法的 18 岁以下儿童进行回顾性分析。
共纳入 100 名 6-17 岁的儿童。大多数儿童患有银屑病（74 例）、特应性皮炎（10 例）或白癜风（8 例），其他儿童患有罕见皮肤病。46%的所有纳入儿童和 42%（36/86）接受 NB-UVB 治疗的儿童出现 2 级红斑或以上；然而，3 级和 4 级反应较为罕见，仅 3 名儿童因灼伤而停止治疗。NB-UVB 对银屑病患者尤其有效；65 例（85%）显著改善，72%在 2 年后未复发。然而，其在特应性皮炎中的疗效不那么令人信服；在一小部分儿童中，6/10（60%）显著改善，但 66%在 3 个月内复发。
我们的分析表明，NB-UVB 对儿童银屑病和白癜风有效，有可能在银屑病中实现长时间缓解。其在特应性皮炎中的疗效尚不明确。NB-UVB 在儿童中的长期安全性仍不清楚，但它似乎是一种耐受性良好的治疗方法，在考虑为各种炎症性皮肤病进行免疫抑制治疗之前，应在儿童中考虑使用 NB-UVB。
