Photodermatosis Service and Laser Unit, Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Dermatol Ther. 2020 Nov;33(6):e14329. doi: 10.1111/dth.14329. Epub 2020 Oct 6.
Photodynamic therapy (PDT), traditionally used in patients with nonmelanoma skin cancer, has been found to be effective for various inflammatory skin conditions. Daylight-activated PDT (DL-PDT), in which the sun serves as the light source, is substantially less painful than conventional PDT. This study aimed to determine the safety and efficacy of DL-PDT in a series of patients with chronic hand eczema (CHE). A proof-of-concept prospective design was used. Eight patients diagnosed with CHE at a tertiary dermatology clinic underwent DL-PDT. The first treatment was administered at the clinic and subsequent treatments (up to four total) were self-administered at home at 2-week intervals. Outcome was evaluated with the Investigator Global Assessment (IGA; score 0-4), Dermatology Life Quality Index (DLQI; score 0-24), and blinded review of clinical photographs (graded on a quartile scale by percent improvement). There were six male and two female patients of mean age 35 years. All underwent at least three treatments. The IGA score improved by 2.5 points at 1 month, 2.7 at 3 months, and 2.2 at 6 months post-treatment, and the DLQI score improved by 7.9, 6.6, and 6.1 points, respectively. Clinical photograph grades improved by 2.9 points at 3 months. Side effects were mild and transient. All patients had some degree of recurrence after 6 months of treatment. The self-administered DL-PDT is easy to perform, moderately effective, and safe to use in patients with CHE. Repeated treatments might be required to maintain remission.
光动力疗法(PDT)传统上用于治疗非黑色素瘤皮肤癌,现已被证实对各种炎症性皮肤病有效。日光激活 PDT(DL-PDT),其中阳光作为光源,比传统 PDT 疼痛明显减轻。本研究旨在确定一系列慢性手部湿疹(CHE)患者中 DL-PDT 的安全性和有效性。采用了概念验证的前瞻性设计。在一家三级皮肤科诊所诊断为 CHE 的 8 名患者接受了 DL-PDT。第一次治疗在诊所进行,随后的治疗(最多 4 次)在 2 周的间隔内在家中自行进行。通过研究者全球评估(IGA;评分 0-4)、皮肤病生活质量指数(DLQI;评分 0-24)和临床照片的盲法评估(按改善百分比分 quartile 评分)评估结果。有 6 名男性和 2 名女性患者,平均年龄 35 岁。所有人都至少接受了 3 次治疗。IGA 评分在治疗后 1 个月改善了 2.5 分,3 个月改善了 2.7 分,6 个月改善了 2.2 分,DLQI 评分分别改善了 7.9、6.6 和 6.1 分。临床照片等级在 3 个月时改善了 2.9 分。副作用轻微且短暂。所有患者在治疗 6 个月后均有一定程度的复发。自我管理的 DL-PDT 易于实施,对 CHE 患者中度有效且安全。可能需要重复治疗以维持缓解。