Krutmann J, Diepgen T L, Luger T A, Grabbe S, Meffert H, Sönnichsen N, Czech W, Kapp A, Stege H, Grewe M, Schöpf E
Department of Dermatology, University of Freiburg, Germany.
J Am Acad Dermatol. 1998 Apr;38(4):589-93. doi: 10.1016/s0190-9622(98)70123-9.
The results of an open, single-center study suggested that phototherapy with high doses of UVA1 radiation (UVA1R; 340-400 nm) is effective for acute, severe exacerbations of atopic dermatitis (AD).
The purpose of this study was to assess the effectiveness of high-dose UVA1 phototherapy for acute, severe AD in a randomized multicenter trial in direct comparison with topical glucocorticoid therapy.
Patients were treated with high-dose UVA1R (10 days, 130 J/cm2/day; n = 20), topically with fluocortolone (10 days, 1 x daily; n = 17), or with UVA-UVB therapy (10 days, 1 x daily, minimal erythema dose-dependent; n = 16).
With a clinical scoring system, significant differences in favor of high-dose UVA1R and fluocortolone therapy were observed (p < 0.0001), as compared with UVA-UVB therapy. At day 10, high-dose UVA1R was superior to fluocortolone (p < 0.002) therapy. Serum levels of eosinophil cationic protein and the blood eosinophil count were significantly reduced after high-dose UVA1 or fluocortolone, but not UVA-UVB therapy.
This study confirms the therapeutic effectiveness of high-dose UVA1 monotherapy for treatment of severe exacerbations of AD.
一项开放性单中心研究结果表明，高剂量UVA1辐射（UVA1R；340 - 400纳米）光疗对特应性皮炎（AD）的急性重度加重有效。
本研究的目的是在一项随机多中心试验中，直接比较高剂量UVA1光疗与局部糖皮质激素治疗对急性重度AD的有效性。
患者分别接受高剂量UVA1R治疗（10天，130 J/cm²/天；n = 20）、局部氟轻松治疗（10天，每日1次；n = 17）或UVA - UVB治疗（10天，每日1次，依最小红斑量而定；n = 16）。
采用临床评分系统，与UVA - UVB治疗相比，观察到高剂量UVA1R和氟轻松治疗有显著差异（p < 0.0001）。在第10天，高剂量UVA1R优于氟轻松治疗（p < 0.002）。高剂量UVA1或氟轻松治疗后，嗜酸性粒细胞阳离子蛋白血清水平和血液嗜酸性粒细胞计数显著降低，但UVA - UVB治疗后未降低。
本研究证实了高剂量UVA1单一疗法治疗AD重度加重的治疗有效性。
