Hofer A, Fink-Puches R, Kerl H, Wolf P
Department of Dermatology, University of Graz, Austria.
Br J Dermatol. 1998 Jan;138(1):96-100. doi: 10.1046/j.1365-2133.1998.02032.x.
The therapeutic effectiveness of radiation from a 311 nm ultraviolet B (UVB) lamp (Philips TL-01) in a near vs. far erythemogenic therapy regimen was investigated in 13 patients with widespread, symmetrically distributed psoriasis. The patients received UV therapy starting with 70% of the 311 nm minimal erythema dose (MED) on one randomly chosen half of the body and 35% of the 311 nm MED on the other half. Therapy was given three to five times a week, and the UVB dose in both regimens was increased simultaneously in the same relation. For the 11 patients completing the study, the mean psoriasis area and severity index (PASI) score for the near vs. far erythemogenic treatment side was 21.2 vs. 18.5 before therapy (Wilcoxon's test, not significant), 11.8 vs. 14.4 at week 1 (P = 0.003), 8.2 vs. 12.0 at week 2 (P = 0.004), and 6.6 vs. 15.6 at week 3 (P = 0.005). After 3 weeks, a satisfactory response (i.e. improvement of the initial PASI score by more than 75%) was observed in six of 11 patients on the near erythemogenic treatment side vs. three of 11 patients on the far erythemogenic side. However, the definitive median total number of treatments needed to achieve a satisfactory therapy response on the near vs. far erythemogenic sides was 12 vs. 16 (P = 0.022), whereas the definitive median cumulative UV dose was 14.0 vs. 9.1 J/cm2 (P = 0.088), respectively. These results suggest that near erythemogenic 311 nm UVB therapy may clear psoriasis faster than far erythemogenic therapy but that the latter regimen may be equally effective as it requires slightly more treatment sessions at a lower (and possibly less carcinogenic) cumulative UV dose.
在13例患有广泛、对称分布银屑病的患者中，研究了311纳米紫外线B（UVB）灯（飞利浦TL - 01）在近红斑量与远红斑量治疗方案下的治疗效果。患者接受紫外线治疗，在随机选择的身体一侧开始使用311纳米最小红斑量（MED）的70%，另一侧使用311纳米MED的35%。每周进行三到五次治疗，两种方案中的UVB剂量以相同比例同时增加。对于完成研究的11名患者，近红斑量治疗侧与远红斑量治疗侧在治疗前的银屑病面积和严重程度指数（PASI）平均得分分别为21.2和18.5（Wilcoxon检验，无显著性差异），第1周时分别为11.8和14.4（P = 0.003），第2周时分别为8.2和12.0（P = 0.004），第3周时分别为6.6和15.6（P = 0.005）。3周后，11名近红斑量治疗侧患者中有6名观察到满意的反应（即初始PASI得分改善超过75%），而11名远红斑量治疗侧患者中有3名。然而，在近红斑量与远红斑量治疗侧达到满意治疗反应所需的最终治疗次数中位数分别为12次和16次（P = 0.022），而最终累积紫外线剂量中位数分别为14.0 J/cm²和9.1 J/cm²（P = 0.088）。这些结果表明，近红斑量311纳米UVB治疗可能比远红斑量治疗更快清除银屑病，但后者方案可能同样有效，因为它需要在较低（且可能致癌性较低）的累积紫外线剂量下进行稍多的治疗疗程。
