Medium-dose ultraviolet (UV) A1 vs. narrowband UVB phototherapy in atopic eczema: a randomized crossover study.
BACKGROUND
Ultraviolet (UV) A1 and narrowband (NB)-UVB have been reported to be effective treatments for atopic eczema (AE).


OBJECTIVE
We aimed to compare the efficacy of medium-dose UVA1 and NB-UVB mono-phototherapy in patients with AE.


METHODS
A randomized double-blind controlled crossover trial (ClinicalTrials.gov Identifier: NCT00419406) was conducted in which patients with AE received a 6-week course of both medium-dose UVA1 and NB-UVB. Clinical efficacy was assessed using the Six Area, Six Sign, Atopic Dermatitis (SASSAD) score and a visual analogue scale for pruritus. Assessment of health-related quality of life was performed using the Skindex-29. Total immunoglobulin E (IgE) and eosinophilic cationic protein (ECP) were evaluated at baseline and after each phototherapy course.


RESULTS
Twenty-eight patients who completed both UVA1 and NB-UVB phototherapy courses on an intention-to-treat basis were analysed according to the crossover design. Both interventions were associated with significant clinical improvement but there was no significant difference between treatments with respect to the mean +/- SD relative reduction (RR) of the clinical scores (SASSAD, 43.7 +/- 31.4% vs. 39.4 +/- 24.1%, P = 0.5; pruritus score, 16 +/- 61.8% vs. 25.2 +/- 30.5%, P = 0.5, respectively). There was no significant difference in the mean +/- SD RR of the Skindex-29 after UVA1 and NB-UVB phototherapy (12.7 +/- 18.8% vs. 16.5 +/- 17.6%, P = 0.1). Changes in the total IgE and ECP levels following UVA1 and NB-UVB did not differ significantly (P = 0.3 and P = 0.9, respectively).


CONCLUSIONS
A 6-week course of NB-UVB and UVA1 phototherapy of AE resulted in significant clinical improvement. With regard to efficacy and tolerability, both phototherapeutic modalities may be considered comparably good.
Gambichler
T
T
Department of Dermatology, Ruhr-University of Bochum, Gudrunstr. 56, D-44791 Bochum, Germany. t.gambichler@klinikum-bochum.de
Othlinghaus
N
N
Tomi
N S
NS
Holland-Letz
T
T
Boms
S
S
Skrygan
M
M
Altmeyer
P
P
Kreuter
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D003876:Dermatitis, Atopic / Q000276:immunology / Q000532:radiotherapy*; D004311:Double-Blind Method; D047150:Eosinophil Cationic Protein / Q000097:blood; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult
D007073:Immunoglobulin E; D047150:Eosinophil Cationic Protein