The effectiveness of high-dose ultraviolet A-1 phototherapy for acute exacerbation of atopic dermatitis in Asians

Photodermatol Photoimmunol Photomed. 2020 Jul;36(4):263-270. doi: 10.1111/phpp.12546. Epub 2020 Mar 18.

Abstract

Background/purpose: Atopic dermatitis (AD) is an inflammatory skin disease characterized by a chronic course of exacerbations and remissions. High-dose ultraviolet A-1 (UVA-1) phototherapy has been effective in the treatment of acute exacerbations of AD. However, there have been no case studies in Asian patients to date. We investigated the effectiveness of high-dose UVA-1 phototherapy for treating acute exacerbation of AD in Asian patients.

Method: This study included 16 patients with acute exacerbation of AD. High-dose (100 J/cm2 ) regimens of UVA-1 therapy were employed. Therapeutic effectiveness was assessed based on the findings of clinical examinations and scoring of AD (SCORAD) index before treatment and after the 5th and 10th sessions of treatment. Additionally, side effects and recurrence during follow-up were retrospectively evaluated.

Results: The patients were between 7 and 50 years of age, with a mean age of 25.8 years. The SCORAD index was between 41 and 89.5, with a mean score of 64.9. Among the 16 patients, two patients discontinued treatment due to the aggravation of erythema and pruritus. Of the 14 patients who completed the 10 sessions of high-dose UVA-1 phototherapy, nine patients (64.3%) showed complete remission and five patients (35.7%) showed partial remission. The mean SCORAD index reduced from 64.9 (before treatment) to 23.3 (after the 10th session of treatment).

Conclusion: This is the first case study of high-dose UVA-1 phototherapy for acute exacerbation of AD in Asian patients, suggesting that high-dose UVA-1 phototherapy can be a well-tolerated and effective treatment for acute exacerbated AD. Future large-scale prospective studies are needed.

Keywords: acute exacerbated atopic dermatitis; high-dose ultraviolet a-1; phototherapy.

MeSH terms

  • Adolescent
  • Adult
  • Asian People
  • Child
  • Dermatitis, Atopic / radiotherapy*
  • Disease Progression
  • Female
  • Humans
  • Hyperpigmentation / etiology
  • Male
  • Middle Aged
  • Pruritus / etiology
  • Recurrence
  • Severity of Illness Index
  • Treatment Outcome
  • Ultraviolet Therapy / adverse effects
  • Ultraviolet Therapy / methods*
  • Young Adult