Department of Dermatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
Department of Internal Medicine and Rheumatology, Leszek Giec Upper-Silesian Medical Centre of the Silesian Medical University in Katowice, Katowice, Poland.
Dermatol Ther. 2022 Jun;35(6):e15478. doi: 10.1111/dth.15478. Epub 2022 Apr 12.
Phototherapy is a recommended treatment regimen for different scleroderma spectrum disorders, but so far it has been included neither by European nor by worldwide experts committee in recommendations for the treatment of systemic sclerosis (SSc). The aim of the study was to revisit the utility of dermatological phototherapy in patients with SSc. PubMed using medical subject headings was searched to identify studies evaluating response to dermatological phototherapy in SSc patients. Both UVA1 (340-400 nm) and PUVA (psoralen plus UVA) treatments were found to reduce skin thickening and increase skin elasticity, therefore allowing for the improvement of joint tension mobility, especially in hands. At least several papers showed efficacy of phototherapy in patients who remained non-responsive to previous immunosuppressive therapies. The most probable mechanisms of action of phototherapy in SSc include inhibition of T-cells and prevention from dermal fibrosis. Although most data on the efficacy of phototherapy come from small experimental studies and case reports, phototherapy based on UVA of wavelength manifests relatively mild spectrum of side effects and this should be considered as a treatment option for SSc with dominant cutaneous involvement.
光疗是治疗不同硬皮病谱系障碍的推荐治疗方案，但到目前为止，它既没有被欧洲专家委员会，也没有被全球专家委员会纳入系统性硬皮病（SSc）治疗建议中。本研究旨在重新评估皮肤科光疗在 SSc 患者中的应用价值。通过使用医学主题词在 PubMed 上进行检索，以确定评估皮肤科光疗在 SSc 患者中的反应的研究。UVA1（340-400nm）和 PUVA（补骨脂素加 UVA）治疗均被发现可减少皮肤增厚并增加皮肤弹性，从而改善关节张力和活动性，尤其是手部。至少有几篇论文表明光疗对以前免疫抑制治疗无反应的患者有效。光疗在 SSc 中的作用机制可能包括抑制 T 细胞和预防皮肤纤维化。尽管关于光疗疗效的大多数数据来自小型实验研究和病例报告，但基于波长为 UVA 的光疗具有相对较轻的副作用谱，因此应将其视为以皮肤受累为主的 SSc 的治疗选择之一。
