Premium
Medium‐dose ultraviolet (UV) A1 vs. narrowband UVB phototherapy in atopic eczema: a randomized crossover study
Author(s) -
Gambichler T.,
Othlinghaus N.,
Tomi N.S.,
HollandLetz T.,
Boms S.,
Skrygan M.,
Altmeyer P.,
Kreuter A.
Publication year - 2009
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.2008.08984.x
Subject(s) - medicine , atopic dermatitis , crossover study , dermatology , randomized controlled trial , immunoglobulin e , adverse effect , ultraviolet b , allergy , ultraviolet therapy , gastroenterology , antibody , immunology , placebo , psoriasis , pathology , alternative medicine
Summary Background Ultraviolet (UV) A1 and narrowband (NB)‐UVB have been reported to be effective treatments for atopic eczema (AE). Objectives We aimed to compare the efficacy of medium‐dose UVA1 and NB‐UVB mono‐phototherapy in patients with AE. Methods A randomized double‐blind controlled crossover trial (ClinicalTrials.gov Identifier: NCT00419406) was conducted in which patients with AE received a 6‐week course of both medium‐dose UVA1 and NB‐UVB. Clinical efficacy was assessed using the Six Area, Six Sign, Atopic Dermatitis (SASSAD) score and a visual analogue scale for pruritus. Assessment of health‐related quality of life was performed using the Skindex‐29. Total immunoglobulin E (IgE) and eosinophilic cationic protein (ECP) were evaluated at baseline and after each phototherapy course. Results Twenty‐eight patients who completed both UVA1 and NB‐UVB phototherapy courses on an intention‐to‐treat basis were analysed according to the crossover design. Both interventions were associated with significant clinical improvement but there was no significant difference between treatments with respect to the mean ± SD relative reduction (RR) of the clinical scores (SASSAD, 43·7 ± 31·4% vs. 39·4 ± 24·1%, P = 0·5; pruritus score, 16 ± 61·8% vs. 25·2 ± 30·5%, P = 0·5, respectively). There was no significant difference in the mean ± SD RR of the Skindex‐29 after UVA1 and NB‐UVB phototherapy (12·7 ± 18·8% vs. 16·5 ± 17·6%, P = 0·1). Changes in the total IgE and ECP levels following UVA1 and NB‐UVB did not differ significantly ( P = 0·3 and P = 0·9, respectively). Conclusions A 6‐week course of NB‐UVB and UVA1 phototherapy of AE resulted in significant clinical improvement. With regard to efficacy and tolerability, both phototherapeutic modalities may be considered comparably good.