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窄谱 UVB 光疗和补骨脂素加 UVA 光化学疗法治疗泛发性扁平苔藓的疗效:来自大型回顾性分析和文献更新的结果。

Effectiveness of narrowband UVB phototherapy and psoralen plus UVA photochemotherapy in the treatment of generalized lichen planus: Results from a large retrospective analysis and an update of the literature.

机构信息

Department of Dermatology, Medical University of Vienna, Vienna, Austria.

出版信息

Photodermatol Photoimmunol Photomed. 2022 Mar;38(2):104-111. doi: 10.1111/phpp.12723. Epub 2021 Aug 11.

Abstract

BACKGROUND

The aim of this retrospective study was to compare the efficacy and safety of different phototherapeutic modalities in the treatment of cutaneous lichen planus (LP).

METHODS

We retrospectively analyzed the chart data of 53 patients with generalized LP who had been subjected to narrowband UVB (NB-UVB) or photochemotherapy (PUVA) between January 1997 and April 2020. Of these, 30 patients had received NB-UVB, 18 patients oral PUVA and 5 patients bath PUVA.

RESULTS

Fifty patients completed a full treatment course. The percentage of patients with a complete (>90% clearing) or good (51%-90% clearing) response was similar for NB-UVB versus PUVA (86.2% vs. 90.5%; P = 1.00). The number of exposures required for obtaining a complete or good response was also comparable for both treatment groups (NB-UVB: 28.9 ± 12.3 vs. PUVA: 25.4 ± 10.1; P = .209). Adverse events, in particular gastrointestinal upsets, were recorded in 26.1% of patients treated with oral PUVA while none were observed with NB-UVB.

CONCLUSION

The therapeutic outcome and the number of treatments required for achieving a complete or good response were comparable for NB-UVB and PUVA; however, PUVA therapy was associated with a substantially higher rate of moderate adverse events.

摘要

背景

本回顾性研究旨在比较不同光疗方法治疗皮肤扁平苔藓(LP)的疗效和安全性。

方法

我们回顾性分析了 1997 年 1 月至 2020 年 4 月间接受窄谱 UVB(NB-UVB)或光化学疗法(PUVA)治疗的 53 例泛发性 LP 患者的图表数据。其中 30 例接受 NB-UVB 治疗,18 例口服 PUVA 治疗,5 例沐浴 PUVA 治疗。

结果

50 例患者完成了全程治疗。NB-UVB 与 PUVA 治疗的完全(>90%清除)或良好(51%-90%清除)应答率相似(86.2%对 90.5%;P=1.00)。两组获得完全或良好应答所需的治疗次数也相似(NB-UVB:28.9±12.3 对 PUVA:25.4±10.1;P=0.209)。口服 PUVA 治疗的患者中有 26.1%出现不良反应,特别是胃肠道不适,而 NB-UVB 治疗组则无不良反应。

结论

NB-UVB 和 PUVA 的治疗效果和获得完全或良好应答所需的治疗次数相当;然而,PUVA 治疗与更高比例的中度不良反应相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2113/9291473/67a17f179ec9/PHPP-38-104-g001.jpg

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