'High dose' vs. 'medium dose' UVA1 phototherapy in italian patients with severe atopic dermatitis.

Pacifico, A; Iacovelli, P; Damiani, G; Ferraro, C; Cazzaniga, Simone; Conic, R R Z; Leone, G; Morrone, A (2019). 'High dose' vs. 'medium dose' UVA1 phototherapy in italian patients with severe atopic dermatitis. Journal of the European Academy of Dermatology and Venereology, 33(4), pp. 718-724. Blackwell 10.1111/jdv.15362

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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 UVA1 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 UVA1 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 ) UVA1 protocol while 14 out of 27 patients received medium dose (60 J/cm ) UVA1 protocol. Phototherapy was performed five times weekly up to 3 weeks. Before and after UVA1 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 UVA1 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 UVA1 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 UVA1 phototherapy is more effective than medium dose in the treatment of adult patients with severe AD.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology

UniBE Contributor:

Cazzaniga, Simone

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0926-9959

Publisher:

Blackwell

Language:

English

Submitter:

Sandra Nyffenegger

Date Deposited:

12 Feb 2019 14:11

Last Modified:

31 Mar 2019 01:31

Publisher DOI:

10.1111/jdv.15362

PubMed ID:

30468530

BORIS DOI:

10.7892/boris.123393

URI:

https://boris.unibe.ch/id/eprint/123393

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