‘High dose’ vs. ‘medium dose’ UVA1 phototherapy in italian patients with severe atopic dermatitis
| Autor: | Carmela Ferraro, Alessia Pacifico, Simone Cazzaniga, Rosalynn R.Z. Conic, Aldo Morrone, Giovanni Leone, Paolo Iacovelli, Giovanni Damiani |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Skin type Dark skin Skin Pigmentation Dermatology Severity of Illness Index Article Dermatitis Atopic law.invention Young Adult 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Severity of illness Severe atopic dermatitis Humans Medicine Young adult business.industry Radiotherapy Dosage Middle Aged Regimen Treatment Outcome Infectious Diseases Italy 030220 oncology & carcinogenesis Comparison study Female Ultraviolet Therapy business |
| Zdroj: | Journal of the European Academy of Dermatology and Venereology. 33:718-724 |
| ISSN: | 1468-3083 0926-9959 |
| Popis: | BACKGROUND: the current evidences attest UVA1 phototherapy as effective in the treatment of severe atopic dermatitis (AD). Furthermore in this indication, “medium dose” is as effective as “high dose” regimen in this indication. To date, a randomized comparison study evaluating the effectiveness as well as safety of different UVA1 protocols in different skin types in the treatment of adult patients with severe AD is still lacking. OBJECTIVE: The aim of the present study was to compare the safety and the efficacy of medium and high dose UVA1 either in fair or in dark skin types. which are more common among Italian population. METHODS: Twenty-seven adult patients with severe AD were consecutively included in a randomized, controlled, open, two arms trial prospective, open, randomized, 2 arms study. Severity of AD was determined by means of SCORAD index and clinical improvement was also monitored. A total of 13/27 patients were treated with High Dose (130 J/cm(2)) UVA1 protocol while 14/27 patients received Medium Dose (60 J/cm(2)) UVA1 protocol. Phototherapy was performed 5 times weekly up to 3 weeks. Before and after UVA1 treatment each patient was evaluated for skin pigmentation through Melanin Index (MI) quantitative evaluation. RESULTS: Skin status improved in all patients resulting in a reduction of SCORAD index in all groups. Our results demonstrated that among patients with darker skin types and higher MI, High dose UVA1 was significantly more effective than Medium Dose (p < 0.0001) while within the groups with skin type II, no significant differences between high and medium dose protocols were observed. CONCLUSION: Our study, further confirms previous observations that UVA1 phototherapy should be considered among the first approaches in the treatment of patients with severe generalized atopic dermatitis and also demonstrates that in darker skin types, high dose UVA1 phototherapy is more effective than medium dose in the treatment of adult patients with severe AD. |
| Databáze: | OpenAIRE |
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