High-dose UVA1 therapy for atopic dermatitis: Results of a multicenter trial - 09/09/11

Doi : 10.1016/S0190-9622(98)70123-9

Jean Krutmann, MD^a*, Thomas L. Diepgen, MD^b, Thomas A. Luger, MD^c, Stephan Grabbe, MD^c, Hans Meffert, MD^d, Niels Sönnichsen, MD^d, Wolfgang Czech, MD^a, Alexander Kapp, MD^a‡, Helger Stege, MD^a*, Markus Grewe, MD^a*, Erwin Schöpf, MD^a
Freiburg, Erlangen, Münster, and Berlin, Germany
From the Departments of Dermatology, University of Freiburg,^a University of Erlangen,^b University of Münster,^c University of Berlin (Charité).^d
^* Present address: Clinical and Experimental Photodermatology, Department of Dermatology, University of Düsseldorf, Germany. ^‡ Present address: Department of Dermatology, Hannover Medical University, Germany

Abstract

Background: 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). Objective: 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. Methods: 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). Results: 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. Conclusion: This study confirms the therapeutic effectiveness of high-dose UVA1 monotherapy for treatment of severe exacerbations of AD. (J Am Acad Dermatol 1998;38:589-93.)

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Plan

PATIENTS AND METHODS

Study design

Randomization, stratification, and treatment

Assessment of therapeutic effectiveness

Statistical analysis

RESULTS

DISCUSSION

	Reprint requests: Jean Krutmann, MD, Professor of Dermatology, Clinical and Experimental Photodermatology, Department of Dermatology, Heinrich-Heine-University, Moorenstr. 5, D-40225 Düsseldorf, Germany.
	0190-9622/98/$5.00 + 0 16/1/88399

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Vol 38 - N° 4

P. 589-593 - avril 1998 Retour au numéro

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Successful monotherapy of severe and intractable atopic dermatitis by photopheresis
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High-dose UVA1 therapy for atopic dermatitis: Results of a multicenter trial - 09/09/11

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