title: Targeted 307 nm UVB-phototherapy in psoriasis. A pilot study comparing a 307 nm excimer light with topical dithranol.
abstract: BACKGROUND
  Phototherapy is a cornerstone in treatment of moderate-to-severe psoriasis. Narrow-band UVB has been shown to be a potent therapeutic tool. To reduce the potential carcinogenic risk, targeted phototherapy has been developed using excimer lasers or excimer light devices (ELD).
  
  
  OBJECTIVE
  The role of excimer light therapy in practice and modes of action are not completely understood. We wanted to investigate a 307 nm ELD for plaque psoriasis in comparison with topical dithranol therapy twice daily.
  
  
  METHODS
  We conducted a pilot trial in 21 adult patients with moderate plaque-type psoriasis. Two target lesions of comparable size and plaque-modified Psoriasis Activity and Severity Index (PSI) scores were selected. Lesion A was treated three times using a newly developed 307 nm ELD. Lesion B was treated twice daily with dithranol ointment. The mean period of treatment was 9 days. Clinical evaluation included PSI scores, safety, time needed to treat, and patient's satisfaction. In addition, fluorescence-remission imaging technique was used for objective evaluation.
  
  
  RESULTS
  Both treatments improved the PSI score (mean 3.0 points). The treatments were safe but ELD was more convenient for patients. The time needed to treat the target lesion was significantly shorter with ELD. Targeted UVB therapy normalized NADH fluorescence in lesional skin.
  
  
  CONCLUSIONS
  The 307 nm excimer light therapy for plaque type psoriasis was equipotent to twice daily topical dithranol. Efficacy, safety, and convenience suggest that targeted UVB therapy with quasi monochromatic light is a new useful treatment option for patients with limited psoriatic plaques.
authors.affiliation: Department of Dermatology and Allergology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of Technical University of Dresden, Dresden, Germany. wollina-uw@khdf.de
authors.forename: Uwe
authors.initials: U
authors.lastname: Wollina
authors.forename: André
authors.initials: A
authors.lastname: Koch
authors.forename: Armin
authors.initials: A
authors.lastname: Scheibe
authors.forename: Bernd
authors.initials: B
authors.lastname: Seme
authors.forename: Ingolf
authors.initials: I
authors.lastname: Streit
authors.forename: Wolf-Dieter
authors.initials: WD
authors.lastname: Schmidt
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000875:Anthralin / Q000008:administration & dosage* / Q000009:adverse effects; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D054018:Lasers, Excimer / Q000009:adverse effects / Q000627:therapeutic use; D028022:Low-Level Light Therapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011565:Psoriasis / Q000188:drug therapy* / Q000532:radiotherapy*; D012720:Severity of Illness Index; D014467:Ultraviolet Therapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*
chemical_list: D003879:Dermatologic Agents; D000875:Anthralin