A comparative non randomized study of narrow-band (NB) (312 +/- 2 nm) UVB phototherapy versus sequential therapy with oral administration of low-dose Cyclosporin A and NB-UVB phototherapy in patients with severe psoriasis vulgaris.
Sequential therapy may improve the efficacy and safety of single treatments for severe psoriasis. We compared sequential Cyclosporin A and narrow-band UVB phototherapy versus narrow-band UVB phototherapy alone. A group of 30 patients with severe psoriasis received 3 mg/kg/day Cyclosporin A for 4 weeks. Afterwards, Cyclosporin A was rapidly tapered and phototherapy begun. An additional 30 patients received phototherapy alone. Treatments were given until psoriasis cleared or until partial improvement was achieved without further amelioration despite another week of treatment. Both treatments were highly effective and well tolerated but sequential therapy was more effective in lesions of UV-shielded body areas; itching disappeared more quickly. The cumulative narrow-band UVB dosages and number of exposures were lower. No difference was seen at follow-up extended up to 9 months. Sequential therapy was well tolerated and allowed for the reduction of narrow-band UVB dosage and exposures, quick relief of itching and improvement of UV-shielded lesions.
Calzavara-Pinton
Piergiacomo
P
Department of Dermatology, Azienda Spedali Civili di Brescia, Brescia, Italy. calzavar@osp.unibs.it
Leone
Giovanni
G
Venturini
Marina
M
Sala
Raffaella
R
Colombo
Delia
D
La Parola
Ilaria Lesnoni
IL
Sitzia
Nathalie
N
Ferraro
Carmela
C
Picardo
Mauro
M
D000284:Administration, Oral; D000328:Adult; D003131:Combined Modality Therapy; D016572:Cyclosporine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011565:Psoriasis / Q000188:drug therapy*; D012720:Severity of Illness Index; D014467:Ultraviolet Therapy
D007166:Immunosuppressive Agents; D016572:Cyclosporine