Long-term application of extracorporeal photochemotherapy in severe atopic dermatitis.
BACKGROUND
Extracorporeal photochemotherapy (ECP) using UVA irradiation of enriched leukocytes in the presence of methoxsalen as a photoactivatable substrate has been employed for the treatment of several immunologically mediated disorders.


OBJECTIVE
Our purpose was to determine the efficacy and safety of long-term ECP in the treatment of severe atopic dermatitis.


METHODS
Fourteen patients with severe recalcitrant atopic dermatitis were treated with ECP in an open clinical trial at 2-week intervals. Disease activity was scored before each ECP cycle by means of a standardized protocol.


RESULTS
A complete clinical remission was achieved in 4 patients (29%). Five patients (36%) experienced a substantial response with reduction of skin inflammation by at least 75%, whereas in one patient (7%) disease activity was reduced by more than 50%. Four patients were withdrawn from the study for unresponsiveness. No clinical signs of immunosuppression or other severe adverse events became evident.


CONCLUSIONS
Long-term ECP may have significant beneficial effects on the course of atopic dermatitis and should therefore be considered as a treatment modality for patients suffering from severe and otherwise refractory atopic skin disease.
Prinz
B
B
Department of Dermatology, Ludwig-Maximilians-University, Munich, FRG.
Michelsen
S
S
Pfeiffer
C
C
Plewig
G
G
D000328:Adult; D000368:Aged; D003876:Dermatitis, Atopic / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004869:Equipment Safety; D005112:Extracorporeal Circulation / Q000295:instrumentation; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000187:drug effects*; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy / Q000295:instrumentation; D016896:Treatment Outcome