Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2022 Dec;25(12):820-823.
The adherence to a narrowband ultraviolet B (NB-UVB) treatment plan is derived, in large part, from the patient's skin tolerance to the phototherapy dose. At present, the initial and first-month incremental phototherapy doses are determined prior to treatment initiation based on the patient's Fitzpatrick skin phototyping.
To identify variables that predict adherence to NB-UVB first-month treatment dosage plan.
Charts of 1000 consecutive patients receiving NB-UVB at a hospital-based phototherapy unit were retrospectively analyzed. We included patients receiving NB-UVB for atopic dermatitis, psoriasis, vitiligo, and mycosis fungoides. The first-month NB-UVB treatment plan was determined based on the patient's Fitzpatrick phototype. Adherence to treatment was defined as receiving at least 80% of the planned first-month cumulative dose. We compared adherent vs. non-adherent patient groups for age, sex, Fitzpatrick phototype, presence of freckles, nevus count category, and type of dermatological disease.
The study included 817 eligible patients, mean age 40 (2-95) years; 54% men; 32% had Fitzpatrick phototype I-II. Distribution by diagnosis was atopic dermatitis (29%), psoriasis (27%), vitiligo (23%), and mycosis fungoides (21%). Adherence to NB-UVB treatment plan was observed in 71% of patients. Adherence decreased with age, with 7% decrease per year (P = 0.03) and was higher among mycosis fungoides patients (77.3%) compared to all other diagnoses (69.8%; P = 0.02).
Adherence to NB-UVB treatment may be related to age and diagnosis. Fitzpatrick phototype-based first-month treatment plans should be modified accordingly.
窄谱中波紫外线（NB-UVB）治疗方案的依从性在很大程度上取决于患者对光疗剂量的皮肤耐受性。目前，在开始治疗之前，根据患者的 Fitzpatrick 皮肤光型来确定初始和第一个月的递增光疗剂量。
确定预测 NB-UVB 第一个月治疗剂量方案依从性的变量。
回顾性分析了在一家医院光疗科接受 NB-UVB 治疗的 1000 例连续患者的图表。我们纳入了接受 NB-UVB 治疗特应性皮炎、银屑病、白癜风和蕈样肉芽肿的患者。第一个月的 NB-UVB 治疗计划是根据患者的 Fitzpatrick 光型确定的。治疗依从性定义为接受至少 80%的计划第一个月累积剂量。我们比较了依从性和非依从性患者组的年龄、性别、Fitzpatrick 光型、雀斑、痣计数类别和皮肤病类型。
该研究纳入了 817 名符合条件的患者，平均年龄 40（2-95）岁；54%为男性；32%为 Fitzpatrick 光型 I-II。按诊断分布为特应性皮炎（29%）、银屑病（27%）、白癜风（23%）和蕈样肉芽肿（21%）。NB-UVB 治疗方案的依从性在 71%的患者中观察到。依从性随年龄而降低，每年降低 7%（P=0.03），蕈样肉芽肿患者的依从性（77.3%）高于所有其他诊断（69.8%；P=0.02）。
NB-UVB 治疗的依从性可能与年龄和诊断有关。应相应修改基于 Fitzpatrick 光型的第一个月治疗计划。
