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局限性 308nm 准分子光与靶向 311nm 窄谱中波紫外线治疗白癜风的疗效比较:一项随机、单盲对比研究。

Comparative efficacy between localized 308-nm excimer light and targeted 311-nm narrowband ultraviolet B phototherapy in vitiligo: A randomized, single-blind comparison study.

机构信息

Institute of Dermatology, Department of Medical Services, Ministry of Public Health, Bangkok, Thailand.

出版信息

Photodermatol Photoimmunol Photomed. 2021 Mar;37(2):123-130. doi: 10.1111/phpp.12619. Epub 2020 Oct 24.

DOI:10.1111/phpp.12619
PMID:33047405
Abstract

BACKGROUND

There are limited data to compare efficacy between recent 308-nm excimer and conventional 311-nm narrowband ultraviolet B (NB-UVB) light in the treatment of vitiligo.

OBJECTIVE

To compare efficacy between 308-nm excimer light and 311-nm NB-UVB in patients with symmetrical vitiligo lesions.

METHODS

Thirty-six symmetrically paired vitiligo lesions on the same anatomical area were enrolled. One side of the symmetrical lesions was treated with localized 308-nm excimer light, and the opposite side was treated with targeted 311-nm NB-UVB assigned randomly by computer. All lesions were treated with the same protocol, for 48 sessions. Repigmentation was evaluated using Vitiligo Area Scoring Index (VASI) and grading the repigmentation was carried out with three independent investigators.

RESULTS

Thirty-six symmetrically vitiligo lesions were randomly treated, one side with 308-nm excimer light and the opposite side with 311-nm NB-UVB. After 48 sessions, a significantly lower VASI score and a higher grade of repigmentation were observed in 308-nm excimer light-treated side (P < .001). Nine lesions (25%) treated with 308-nm excimer light and only five lesions (13.89%) treated with 311-nm NB-UVB achieved excellent repigmentation. The 308-nm excimer light and 311-nm NB-UVB-treated sides rapidly obtained 25% repigmentation within a mean of 19.42 sessions and 26.25 sessions, respectively (P = .002). There was no significant difference in mean cumulative UV dosage (P = .065). Side effect as phototoxicity was similar in both sides (P = .08).

CONCLUSION

Localized 308-nm excimer light appears to be more effective and also more rapidly induces repigmentation than targeted 311-nm NB-UVB for treatment of vitiligo.

摘要

背景

在治疗白癜风方面,最近的 308nm 准分子激光与传统的 311nm 窄谱中波紫外线(NB-UVB)光的疗效比较数据有限。

目的

比较 308nm 准分子光与 311nm NB-UVB 在对称型白癜风皮损中的疗效。

方法

共纳入 36 例同一解剖区域的对称型白癜风皮损。采用局部 308nm 准分子光治疗皮损一侧,另一侧采用计算机随机分配的靶向 311nm NB-UVB 治疗。所有皮损均采用相同方案治疗 48 次。采用白癜风面积评分指数(VASI)评估复色情况,并由 3 名独立研究者对复色情况进行分级。

结果

共 36 例对称型白癜风皮损随机分组,一侧采用 308nm 准分子光治疗,另一侧采用 311nm NB-UVB 治疗。治疗 48 次后,308nm 准分子光治疗侧的 VASI 评分明显更低,复色等级更高(P<0.001)。9 例(25%)皮损采用 308nm 准分子光治疗获得极好复色,5 例(13.89%)皮损采用 311nm NB-UVB 治疗获得极好复色。308nm 准分子光和 311nm NB-UVB 治疗侧分别在 19.42 次和 26.25 次治疗时迅速获得 25%复色(P=0.002)。两组累积紫外线剂量均值无显著差异(P=0.065)。两侧的光毒性等不良反应相似(P=0.08)。

结论

与靶向 311nm NB-UVB 相比,局部 308nm 准分子光治疗白癜风的疗效更优,复色更快。

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