Clinical efficacy of the rotation of phototherapy methods (PUVA therapy and mid-wavelength ultraviolet therapy (311 nm)) in patients with moderate to severe forms of psoriasis

Cover Page

Abstract


Goal. To assess the therapeutic efficacy of the rotation of mid-wavelength ultraviolet therapy (311 nm) and PUVA therapy in patients with moderate to severe forms of psoriasis, and to assess the efficacy of mid-wavelength ultraviolet therapy (311 nm) in a multiple-course therapy. Materials and methods. The study involved 66 patients with moderate to severe forms of psoriasis who received multiple courses of treatment by methods of the PUVA therapy and narrowband mid-wavelength phototherapy (311 nm). The patients were divided into three groups: Group 1 (n = 20) - patients who received treatment in the form of mid-wavelength ultraviolet therapy (311 nm) after multiple courses of PUVA therapy; Group 2 (n = 26) - patients who received only multiple courses of PUVA therapy; Group 3 (n = 20) - patients who received only multiple courses of mid-wavelength ultraviolet therapy (311 nm). Results. The authors determined high efficacy (82.8%) of mid-wavelength ultraviolet therapy (311 nm) in patients with moderate to severe forms of psoriasis vulgaris who had previously received multiple courses of PUVA therapy. After multiple courses of long-term treatment by mid-wavelength ultraviolet therapy (311 nm), patients with moderate to severe forms of psoriasis had high efficacy of such multiple courses of treatment (85.78%). Conclusion. Patients with moderate to severe forms of psoriasis who had previously received multiple courses of PUVA therapy can be switched to mid-wavelength ultraviolet therapy (311 nm) with the maintenance of high efficacy of such treatment. The authors observed the absence of any adaptation to the spectral range of mid-wavelength ultraviolet therapy (311 nm) in case of multiple courses of treatment.

M. B. Zhilova

State Research Center of Dermatovenereology and Cosmetology, Ministry of Healthcare of the Russian Federation

Author for correspondence.
Email: zhilova@cnikvi.ru

Russian Federation

V. V. Chikin

State Research Center of Dermatovenereology and Cosmetology, Ministry of Healthcare of the Russian Federation

Email: noemail@neicon.ru

Russian Federation

  1. Kubanova A.A., Kubanov A.A., Nikolas Dzh.F., P'yu L., Prints Dzh., Katunina O.R., Znamenskaya L.F. Immune mechanisms of psoriasis. New strategies of biological therapy. Vestn dermatol venerol, 2010; 1; 35-47.
  2. Lebwohl M. Psoriasis. Lancet. 2003, 361: 1197-204.
  3. Rapp S.R., Feldman S.R., Exum M.L. et al. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol 1999; 41: 401-7.
  4. Huerta C., Rivero E., Garcia Rodriguez L.A. Incidence and risk factors for psoriasis in the general population. Arch Dermatol 2007; 143: 1559-65.
  5. Farber E., Nall M. Epidemiology: Natural History and Genetics. New York: Marcel (1998).
  6. Griffiths C., Barker J. Pathogenesis and clinical features of psoriasis. Lancet 2007; 370: 263-71.
  7. Ferrandiz C., Bordas X., Garcia-Patos V. et al. Prevalence of psoriasis in Spain (Epiderma Project: phase l). J Eur Acad Dermatol Venereol 2001; 15: 20-3.
  8. Simpson C.R., Anderson WJA, Helms P.J. et al. Coincidence of immunemediated diseases driven by Th1 and Th2 subsets suggests a common aetiology. A population-based study using computerized general practice data. Clin Exp Allergy 2002; 32: 37-42.
  9. Tsai T.-F., Wang T.-S., Hung S.-T. et al. Epidemiology and comorbidities of psoriasis patients in a national database in Taiwan. J Dermatol Sci 2011; 63: 40-6.
  10. McClure S.L., Valentine J., Gordon K.B. Comparative tolerability of systemic treatments for plaque-type psoriasis. Drug Saf. 2002; 25 (13): 913-27.
  11. Beani J.C., Jeanmougin M. Narrow-band UVB therapy in psoriasis vulgaris: good practice guideline and recommendations of the French Society of Photodermatology. Ann Dermatol Venereol. 2010, Jan; 137 (1): 21-31.
  12. Melski W., Tanenbaum L., Parrish F.A. et al. Oral methoxsalen photochemotherapy for the treatment of psoriasis: a cooperative clinical trial. J Invest Oermatol 1977; 68: 32835.
  13. Archier E., Devaux S., Castela E., Gallini A., Aubin F., Le Maître M. Efficacy of psoralen UV-A therapy vs. narrowband UV-B therapy in chronic plaque psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol. 2012 May; 26 (3): 11-21.
  14. Brazzelli V., Barbagallo T., Trevisan V., Muzio F., De Silvestri A., Borroni G. The duration of clinical remission of photochemotherapy and narrow-band UV-B phototherapy in the treatment of psoriasis: a retrospective study. Int J Immunopathol Pharmacol. 2008 Apr-Jun; 21 (2): 481-4.
  15. Radakovic S., Seeber A., Hönigsmann H., Tanew A. Failure of short-term psoralen and ultraviolet A light maintenance treatment to prevent early relapse in patients with chronic recurring plaque-type psoriasis.Photodermatol Photoimmunol Photomed. 2009 Apr; 25 (2): 90-3.
  16. Yones S.S., Palmer R.A., Garibaldinos T.T., Hawk J.L. Randomized double-blind trial of the treatment of chronic plaque psoriasis: efficacy of psoralen-UV-A therapy vs narrowband UV-B therapy. Arch Dermatol. 2006 Jul; 142 (7): 836-42.
  17. Collins P., Wainwright N.J., Amorim I., Lakshmipathi T., Ferguson J. 8-MOP PUVA for psoriasis: a comparison of a minimal phototoxic dose-based regimen with a skin-type approach. Br J Dermatol. 1996 Aug; 135 (2): 248-54.
  18. Rusak Yu.E. Course treatment of patients with psoriasis by methods PUVA and UVB. Gigiena truda i sostoyanie zdorov'ya rabochikh gornodobyvayushchey promyshlennosti v Kaz. SSR. Karaganda, 1990; 147-148.
  19. Lindelof B., Sigurgeirsson B., Tegner E. et al. Comparison of the carcinogenic potential of trioxsalen bath PUVA and oral methoxsalen PUVA. Arch Dermatol 1992; 128: 1341-1344.
  20. Lever L.R., Farr P.M. Skin cancers or premalignant lesions occur in half of high-dose PUVA patients. Br J Dermatol 1994; 131: 215-219.
  21. Mc Kenna K.E., Patterson C.C., Handley J. et al. Cutaneous neoplasia following PUVA therapy for psoriasis. Br J Dermatol 1996; 134: 639-642.
  22. Gritiyarangsan P., Sindhavananda J., Rungrai-ratanaroj P. et al. Cutaneous carcinoma and PUVA lentigines in Thai patients treated with oral PUVA. Photodermatol Photoimmunol Photomed 1995; 11: 174-177.
  23. Maier H., Schemper M., Ortel B. et al. Skin tumors in photochemotherapy for psoriasis: a single-center follow-up of 496 patients. Dermatology 1996; 193: 185-191.

Views

Abstract - 337

PDF (Russian) - 32

Refbacks

  • There are currently no refbacks.

Copyright (c)



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies