| The effectiveness of PUVA treatment in severe psoriasis is significantly increased by additional UV 308-nm excimer laser sessions. | |
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MedLine Citation:
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PMID: 18086590 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In most cases, patients with moderate to severe psoriasis are treated with narrow-band UVB phototherapy or with psoralen UVA (PUVA-) photochemotherapy. This UV-radiation is given to the whole skin, including unaffected skin. Normally, these two PUVA- and UVB-radiation procedures cannot be combined on account of the phototherapeutic side-effects on unaffected skin. The 308-nm excimer laser has been shown to be safe and effective in the treatment of localized mild-to-moderate plaque-type psoriasis whilst sparing healthy skin. Our aim was to compare the therapeutic response to PUVA plus up to 4 UVB308-nm radiations and PUVA monotherapy in patients with moderate-severe plaque-type psoriasis. 272 hospitalized adult patients were enrolled on this prospective random study. 256 patients completed the full course of treatment. PUVA treatment was given 4 times weekly to all patients. 123 patients received PUVA as a monotherapy. During the first two weeks, 149 patients were additionally treated up to four times with 308-nm excimer-derived UVB on the affected skin and treatment was evaluated for its efficacy, duration, number of times necessary for complete (CR) or partial remission (PASI reduction > 90 or > 50%, respectively), cumulative light dose, side effects of therapy and duration of remission after therapy. Statistically, there is no significant difference when comparing the efficacy of PUVA (CR 67.3%) and PUVA plus excimer (CR 63.6%). On average, patients treated by the combination method went into remission in half the treatment time (15 +/- 6 versus 27 +/- 7 days) and with half the cumulative UVA dose (22.9 +/- 5.8 versus 53.2 +/- 26.3), p < 0.05. In conclusion, skin heals considerably quicker when treated with a combination of photochemotherapy and a short course of UVB 308 nm laser treatment applied directly to the affected skin, resulting in a shorter hospital stay and quicker rehabilitation of patients with moderate-severe psoriasis. |
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Authors:
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Jana Trott; Wolfgang Gerber; Stefan Hammes; Hans-Michael Ockenfels |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2007-12-18 |
Journal Detail:
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Title: European journal of dermatology : EJD Volume: 18 ISSN: 1167-1122 ISO Abbreviation: Eur J Dermatol Publication Date: 2008 Jan-Feb |
Date Detail:
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Created Date: 2008-01-04 Completed Date: 2008-06-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9206420 Medline TA: Eur J Dermatol Country: France |
Other Details:
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Languages: eng Pagination: 55-60 Citation Subset: IM |
Affiliation:
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Department of Dermatology and Allergology, Klinikum Hanau, Leimenstrasse 20, 63450 Hanau, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Combined Modality Therapy Female Humans Laser Therapy, Low-Level* Lasers, Excimer* Male Middle Aged PUVA Therapy* Psoriasis / drug therapy, therapy* Ultraviolet Therapy |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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