Narrowband ultraviolet B and medium-dose ultraviolet A1 are equally effective in the treatment of moderate to severe atopic dermatitis - 08/08/11

Doi : 10.1016/j.jaad.2008.08.048

I.M. Leonie Majoie, MD ^a,^{^{These authors contributed equally to this study.}}, J. Marja Oldhoff, MD, PhD ^a,^⁎^{^{These authors contributed equally to this study.}} , Huib van Weelden, MSc ^a, Marloes Laaper-Ertmann ^a, Mente T. Bousema, MD ^b, Vigfus Sigurdsson, MD, PhD ^a, Edward F. Knol, PhD ^a, Carla A.F. Bruijnzeel-Koomen, MD, PhD ^a, Marjolein S. de Bruin-Weller, MD, PhD ^a
^a Department of Dermatology and Allergology, University Medical Center Utrecht, The Netherlands
^b Department of Dermatology, Meander Medical Center, Amersfoort, The Netherlands

Reprint requests: J. Marja Oldhoff, MD, PhD, University Medical Center Utrecht, Heidelberglaan 100, Department of Dermatology, G02.124, 3508 GA Utrecht, the Netherlands.

Abstract

Background

Phototherapy may be effective in atopic dermatitis (AD). Medium-dose (MD) ultraviolet (UV) A1 was introduced for the treatment of AD. Few immunohistochemical data are available pertaining to phototherapy in AD. Regulatory T cells may play a role in clearing AD.

Objectives

We sought to compare the clinical and immunohistochemical effects of narrowband (NB) UVB and MD UVA1 treatment in patients with AD.

Methods

Thirteen adult patients with AD were included in this randomized investigator-blinded half-sided comparison study between NB UVB and MD UVA1. Disease activity was measured using the Leicester sign score. Skin biopsy specimens were taken before and after phototherapy. Regulatory T cells were stained with the forkhead box protein P3 (FoxP3).

Results

NB UVB and MD UVA1 both significantly decreased AD severity (P < .01) and the dermal cellular infiltrate. The percentage of FoxP3⁺CD3⁺ T cells did not change after NB UVB or MD UVA1 treatment.

Limitation

MD UVA1 therapy was given 3 times per week instead of the preferred regimen of 5 times per week. This was necessary to achieve good blinding of the study.

Conclusions

NB UVB and MD UVA1 seem equally effective in the treatment of patients with moderate to severe AD. Neither MD UVA1 nor NB UVB had an effect on the percentage of FoxP3⁺CD3⁺ T cells.

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Abbreviations used : AD, FoxP3, LSS, MD, NB, NHuS, PBS, Tregs, UV, UVAB, VAS