Medium-dose is more effective than low-dose ultraviolet A1 phototherapy for localized scleroderma as shown by 20-MHz ultrasound assessment - 07/08/11
Abstract |
Background |
Recent studies suggest that ultraviolet (UV) A1 phototherapy is an effective treatment for localized scleroderma (LS); however, the optimum UVA1 dose remains to be determined.
Objective |
We sought to compare the immediate and long-term efficacy of low- versus medium-dose UVA1 phototherapy for plaque-type LS.
Methods |
Three comparable plaques in 16 patients were treated with 20 J/cm2 UVA1, 70 J/cm2 UVA1, or no irradiation. In total, 30 treatments were given. Skin thickness was determined by high-frequency ultrasound examination and clinical scoring. Assessments were done at baseline, immediately after treatment, and 3, 6, and 12 months thereafter.
Results |
Ultrasound measurement showed a significantly greater reduction of skin thickness with 70 J/cm2 than with 20 J/cm2 at all time points of the study except immediately after UVA1 treatment. The clinical score of the irradiated plaques also decreased substantially but failed to detect a significant difference between the two dose regimens.
Limitations |
Our results only pertain to plaque-type LS and are limited by a small sample size.
Conclusion |
Medium-dose provides for better long-term results than low-dose UVA1 in LS as shown by ultrasound assessment. With clinical scoring, no significant difference between the two UVA1 dose regimens was detected, indicating that ultrasound measurement is a more sensitive method for quantifying treatment-induced skin changes in patients with LS.
Le texte complet de cet article est disponible en PDF.Key words : comparison of low- and medium-dose UVA1, high-frequency ultrasound, long-term follow-up, LS, UVA1 phototherapy
Plan
Funding sources: None. |
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Conflicts of interest: None declared. |
Vol 60 - N° 5
P. 786-791 - mai 2009 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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