Sakuntabhai A, Matthews J N, Farr P M
Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, U.K.
Br J Dermatol. 1994 May;130(5):604-9. doi: 10.1111/j.1365-2133.1994.tb13107.x.
In an attempt to improve the prediction of PUVA erythemal sensitivity, we have examined, in 251 patients, the relationship between the minimal phototoxic dose (MPD) and a number of variables, including skin type, ingested dose of 8-methoxypsoralen (8-MOP) and history of previous PUVA treatment. The MPD was determined by phototesting 2 h after ingestion of crystalline 8-MOP, given at a standard dose of 0.6 mg/kg (calculated to the nearest 10 mg). No reaction to the highest dose of UVA used for phototesting occurred in 16% of cases; the dose of 8-MOP was significantly associated with non-response. In the patients in whom an erythemal response was obtained, a significant association was found between the MPD and the variables of skin type, ingested dose of 8-MOP, and history of previous PUVA treatment. Thus, by taking these factors into account, a more accurate prediction can be made of an individual patient's erythemal sensitivity to PUVA than relying on skin type alone. That erythemal sensitivity is affected by the ingested dose of 8-MOP (even when all patients received 0.6 mg/kg) suggests that conventional psoralen dosing according to body weight is not ideal.
为了提高对补骨脂素紫外线A（PUVA）红斑敏感性的预测，我们对251例患者进行了研究，检测了最小光毒性剂量（MPD）与多个变量之间的关系，这些变量包括皮肤类型、8-甲氧基补骨脂素（8-MOP）的摄入剂量以及既往PUVA治疗史。MPD是在摄入结晶状8-MOP 2小时后通过光试验确定的，8-MOP的标准剂量为0.6mg/kg（四舍五入至最接近的10mg）。16%的病例对用于光试验的最高剂量紫外线A无反应；8-MOP的剂量与无反应显著相关。在获得红斑反应的患者中，发现MPD与皮肤类型、8-MOP摄入剂量和既往PUVA治疗史等变量之间存在显著关联。因此，考虑到这些因素，相比于仅依靠皮肤类型，能够更准确地预测个体患者对PUVA的红斑敏感性。红斑敏感性受8-MOP摄入剂量的影响（即使所有患者均接受0.6mg/kg），这表明根据体重进行传统的补骨脂素给药并不理想。
