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A randomised controlled trial on photo(chemo)therapy of subacute purigo
Author(s) -
Gambichler T.,
Hyun J.,
Sommer A.,
Stücker M.,
Altmeyer P.,
Kreuter A.
Publication year - 2006
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/j.1365-2230.2006.02081.x
Subject(s) - medicine , puva therapy , psoralen , regimen , dermatology , randomized controlled trial , ultraviolet a , gastroenterology , psoriasis , dna , genetics , biology
Summary Background. Psoralen ultraviolet A (PUVA) is the standard photo(chemo)therapeutic regimen for patients suffering from subacute prurigo (SP). Hypothesis. Regarding efficacy, bath PUVA is not superior to medium‐dose ultraviolet‐A1 (MD‐UVA1) and narrowband ultraviolet‐B (NB‐UVB), which may be considered the new photo(chemo)therapeutic options for SP. Methods. We performed a prospective randomised, controlled, three‐arm photo(chemo)therapeutic study. Patients suffering from histopathologically proven SP with a clinical score (PIP score; papules, infiltration and pruritus) of at least 5 points were enrolled into the study. Treatment with bath PUVA was performed 4 times weekly and MD‐UVA1 and NB‐UVB 5 times weekly. Photo(chemo)therapy was administered over a 4‐week period. Outcome measure was the severity of SP investigated by means of the PIP score after 4 weeks of therapy. Results. In total, 33 patients with SP were randomly allocated to photo(chemo)therapy. Bath PUVA ( n = 9), MD‐UVA1 ( n = 11) and NB‐UVB ( n = 13) resulted in a significant reduction of the baseline PIP score as assessed on the basis of intention‐to‐treat (ITT) analysis ( P = 0.003). However, ITT analysis revealed significantly higher PIP score reduction in patients who were treated with bath PUVA and MD‐UVA1 compared with NB‐UVB ( P < 0.01, 95% CI 1.1–3.63 and P < 0.05, 95% CI 0.42–2.70, respectively). Conclusions. Photo(chemo)therapy, including bath PUVA, MD‐UVA1 and NB‐UVB, appears to be an effective and safe treatment option for patients suffering from SP. UVA1 and particularly PUVA seem superior to NB‐UVB in the management of SP.