Premium
‘High dose’ vs. ‘medium dose’ UVA1 phototherapy in italian patients with severe atopic dermatitis
Author(s) -
Pacifico A.,
Iacovelli P.,
Damiani G.,
Ferraro C.,
Cazzaniga S.,
Conic R.R.Z.,
Leone G.,
Morrone A.
Publication year - 2019
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.15362
Subject(s) - medicine , scorad , atopic dermatitis , randomized controlled trial , dermatology , regimen , eczema area and severity index , skin type , dermatology life quality index , psoriasis
Background The current evidences attest UVA1 phototherapy as effective in the treatment of severe atopic dermatitis ( AD ). Furthermore, in this indication, ‘medium dose’ is as effective as ‘high dose’ regimen. To date, a randomized comparison study evaluating the effectiveness as well as safety of different UVA 1 protocols in different skin types in the treatment of adult patients with severe AD is still lacking. Objective The aim of the present study was to compare the safety and the efficacy of medium and high dose UVA 1 either in fair or in dark skin types. Methods Twenty‐seven adult patients with severe AD were consecutively included in a randomized, controlled, open, two arms trial Severity of AD was determined by means of SCORAD index and clinical improvement was also monitored. A total of 13 out of 27 patients were treated with high dose (130 J/cm 2 ) UVA 1 protocol while 14 out of 27 patients received medium dose (60 J/cm 2 ) UVA 1 protocol. Phototherapy was performed five times weekly up to 3 weeks. Before and after UVA 1 treatment each patient was evaluated for skin pigmentation through Melanin Index ( MI ) quantitative evaluation. Results Skin status improved in all patients resulting in a reduction of SCORAD index in all groups. Our results demonstrated that among patients with darker skin types and higher MI , high dose UVA 1 was significantly more effective than medium dose ( P < 0.0001) while within the groups with skin type II , no significant differences between high and medium dose protocols were observed. Conclusion Our study, confirms previous observations that UVA 1 phototherapy should be considered among the first approaches in the treatment of patients with severe generalized AD and also demonstrates that in darker skin types, high dose UVA 1 phototherapy is more effective than medium dose in the treatment of adult patients with severe AD .