Topical psoralen photochemotherapy for atopic dermatitis: evaluation of two therapeutic regimens for inpatients and outpatients.
Forty-seven adolescent and adult patients suffering from long-standing atopic dermatitis (AD) too severe to respond to conventional therapies were treated with topical psoralen photochemotherapy (PUVA) and relatively low doses of ultraviolet (UV) irradiation. For practicality and convenience, two different therapeutic regimens were implemented; short-term hospitalization with almost daily irradiation (inpatient group, n = 23) and weekly irradiation combined with topical corticosteroids which had failed to manage symptoms before initiating the treatment (outpatient group, n = 25). Excellent therapeutic effects were achieved in 72% of the inpatients after 5-38 (mean 18.2) times of irradiation (mean cumulative dose; 44.7 J/cm2). In addition, 56% of outpatients responded excellently to the treatment after 6-22 (mean 13.0) times (mean cumulative dose; 25.8 J/cm2). In fact, 16 of the inpatients and 10 of the outpatients achieved almost complete remission. The duration of remission in these patients was 1-25 months (mean 6.3 months) in the inpatients and 1-6 months (mean 3.0 months) in the outpatients. Peripheral blood eosinophils significantly decreased after the treatments. A follow-up study showed a delayed decrease in serum IgE levels. In contrast, the specific IgE to house dust antigens and the water holding capacity of stratum corneum did not vary after treatment.
Department of Dermatology, Juntendo University School of Medicine, Tokyo, Japan.
T
T
Yoshiike
J
J
Sindhvananda
Y
Y
Aikawa
S
S
Nakajima
H
H
Ogawa
D000293:Adolescent; D000328:Adult; D002648:Child; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D011564:Furocoumarins / Q000008:administration & dosage; D006760:Hospitalization; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D008297:Male; D010045:Outpatients; D011701:PUVA Therapy / Q000009:adverse effects / Q000379:methods*
D011564:Furocoumarins; D007073:Immunoglobulin E