Dawe R S, Wainwright N J, Cameron H, Ferguson J
Department of Dermatology, Ninewells Hospital and Medical School, Dundee, U.K.
Br J Dermatol. 1998 May;138(5):833-9. doi: 10.1046/j.1365-2133.1998.02221.x.
Three and five times weekly narrow-band TL-01 (311-313 nm) ultraviolet (UV) B phototherapy regimens for chronic plaque psoriasis were compared in a randomized, observer-blinded, half-body, within-patient paired study. Twenty-one patients [13 men, eight women, age range 21-68 years, skin phototypes I (two patients), II (14) and III (five)] entered the study. Sixteen reached clearance or minimal residual activity (MRA) on both sides. Of the other five, three withdrew because they did not reach clearance or MRA on the 5x weekly side by a maximum of 30 treatments, one when he was satisfied with moderate improvement and one because of repeated failure to attend. Those who completed treatment reached clearance or MRA after a median of 35 days with 5x weekly treatment compared with 40 days with 3x weekly treatment (P = 0.007), but required a median of 23.5 compared with 17 UVB exposures (P = 0.001) and 94 minimal erythema dose multiples (MEDs) compared with 64 MEDs (P = 0.01). Fifteen (of 16) developed at least one episode of well-demarcated erythema during 5x weekly treatment compared with just three of 16 treated 3x weekly (P < 0.001). There was no significant difference between regimens in duration of remission. For this skin phototype I-III population, the more rapid clearance of psoriasis with 5x weekly phototherapy is not, for the majority of patients, sufficient to justify the extra exposures and higher UVB dose. We no longer use 5x weekly phototherapy for psoriasis.
在一项随机、观察者盲法、半体、患者自身配对研究中，对用于慢性斑块状银屑病的每周3次和5次的窄谱TL-01（311 - 313纳米）紫外线（UV）B光疗方案进行了比较。21名患者[13名男性，8名女性，年龄范围21 - 68岁，皮肤光类型为I型（2例患者）、II型（14例）和III型（5例）]进入研究。16名患者双侧均达到清除或最小残留活动度（MRA）。另外5名患者中，3名退出，因为他们在每周5次治疗组最多接受30次治疗后未达到清除或MRA；1名患者因对中度改善感到满意而退出；1名患者因反复未能就诊而退出。完成治疗的患者中，每周5次治疗组达到清除或MRA的中位时间为35天，而每周3次治疗组为40天（P = 0.007），但每周5次治疗组所需的中位紫外线B照射次数为23.5次，而每周3次治疗组为17次（P = 0.001），最小红斑量倍数（MEDs）为94，而每周3次治疗组为64（P = 0.01）。每周5次治疗的16名患者中有15名至少出现1次界限清晰的红斑发作，而每周3次治疗的16名患者中只有3名出现（P < 0.001）。两种方案在缓解持续时间上无显著差异。对于这种I - III型皮肤人群，对于大多数患者而言，每周5次光疗能更快清除银屑病，但不足以证明额外的照射次数和更高的紫外线B剂量是合理的。我们不再将每周5次光疗用于银屑病治疗。
