St John's Institute for Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Department of Dermatology, Amsterdam UMC, Academic Medical Center, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands.
J Eur Acad Dermatol Venereol. 2024 Mar;38(3):521-529. doi: 10.1111/jdv.19638. Epub 2023 Nov 27.
Phototherapy is used to treat atopic dermatitis (AD). Evidence for its efficacy, impact on quality of life, cost-effectiveness and short- and long-term safety with real-life usage is weak.
We established a taskforce to examine how phototherapy is currently being used as a treatment for AD across the United Kingdom and Europe to inform our understanding and guide future research into management of patients with AD using UV-based phototherapies.
An anonymous electronic multiple-response survey exploring phototherapy prescribing practices and experience of phototherapy modalities was developed by the study authors and sent to members of phototherapy networks from the United Kingdom and Europe. Responses were received between February and July 2021.
About 144 respondents from 27 European countries completed the survey. NBUVB was the most widely used [n = 138 (96%)]. Home-based NBUVB was available in 8/27 countries (25/144 respondents, 17%). Oral psoralen-UVA (PUVA) was more widely available than bath PUVA (n = 106, 74% vs. n = 60, 42%) and used mainly in adult patients. 49/144 (34%) of respondents had access to UVA1. Phototherapy would be considered instead of systemic treatment in 96% of adults and 82% of children for NBUVB, versus 40% of adults and 3% of children for PUVA. Starting doses, standard dosing increments, length of treatment courses, lifetime limits for treatments and thresholds for performing annual skin assessments varied between responders.
NBUVB was the most widely used phototherapy for AD in adult and paediatric patients, while PUVA and UVA1 were less used. Prescribing practices varied considerably, highlighting the lack of consensus practice in many different aspects of phototherapy for the treatment of AD in children and adults. This indicates that further studies are required to determine optimal phototherapeutic regimens for AD and informs our understanding of parameters that should be included in future high-quality randomized controlled trials (RCT) of phototherapy.
光疗用于治疗特应性皮炎（AD）。但是，关于其疗效、对生活质量的影响、成本效益以及实际应用中的短期和长期安全性的证据仍然很薄弱。
我们成立了一个工作组，以检查在英国和欧洲，光疗目前是如何被用作 AD 治疗方法的，从而加深我们对 AD 患者使用基于 UV 的光疗管理的理解，并为未来的相关研究提供指导。
研究作者开发了一份匿名电子多项选择题调查，内容是关于光疗处方实践和光疗方式的经验，然后分发给来自英国和欧洲的光疗网络成员。调查于 2021 年 2 月至 7 月期间收到回复。
来自 27 个欧洲国家的约 144 名受访者完成了调查。窄谱中波紫外线（NBUVB）的使用最为广泛[138 例（96%）]。8 个国家/地区（27 个国家中的 8 个）可提供家庭用 NBUVB[144 名受访者中的 8 名，6%]。口服补骨脂素加 UVA（PUVA）的使用范围比浴用 PUVA 更广泛（n=106，74%比 n=60，42%），主要用于成年患者。144 名受访者中的 49 名（34%）可获得 UVA1。96%的成年患者和 82%的儿童患者会将光疗视为替代全身治疗的方法，而 NBUVB 分别为 40%的成年患者和 3%的儿童患者，PUVA 则为 40%的成年患者和 3%的儿童患者。起始剂量、标准剂量递增、治疗疗程长度、治疗次数终身限制和每年皮肤评估阈值在不同的受访者之间存在差异。
NBUVB 是治疗成人和儿童 AD 患者最常用的光疗方法，而 PUVA 和 UVA1 的使用则较少。处方实践差异很大，这表明在儿童和成人 AD 光疗的许多不同方面缺乏共识实践。这表明需要进一步研究来确定 AD 的最佳光疗方案，并为我们了解未来高质量随机对照试验（RCT）中应包含的参数提供信息。
