Low-dose narrow-band UVB phototherapy combined with topical therapy is effective in psoriasis and does not inhibit systemic T-cell activation.

Type:Uv phototherapy   Time:2017-10-23 14:13:34
Low-dose narrow-band UVB phototherapy combined with topical therapy is effective in psoriasis and does not inhibit 
systemic T-cell activation.
BACKGROUND:
Psoriasis is a chronic T-cell-mediated inflammatory skin disease which can be treated with topical medication, 
phototherapy or systemic medication. A subgroup of psoriatic patients does not respond to monotherapy and needs 
combination therapy. We used low-dose narrow-band UVB phototherapy, combined with balneotherapy, short-contact 
anthralin, liquor carbonis detergens and calcipotriol for treatment of psoriatic patients in our day care centre.
OBJECTIVE:
Our purpose was to study the efficacy, induction of erythema and effect on systemic T-cell activation of this 
combination therapy.
METHODS:
Skin reflectance spectrophotometry was used to measure skin erythema. The Psoriasis Area and Severity Index (PASI) was 
used to evaluate psoriatic patients. Serum soluble IL-2 receptor (sIL2-R) levels were measured by an ELISA.
RESULTS:
The possible erythematogenic effect of low-dose narrow-band UVB irradiation was studied (skin reflectance 
spectrophotometer) in a control group of psoriatic patients (n = 11). No induction of skin erythema was seen. 
Subsequently, this low-dose irradiation regimen was used in combination with topical medication in 26 psoriatic 
patients. A 90% decrease in the PASI was seen after a mean number of 35 treatment sessions. Seventeen patients (65%) 
remained in remission during the following 6 months. Serum sIL-2R levels were elevated in all patients (mean 913 U/ml) 
and did not change during treatment.
CONCLUSION:
Our data indicate that low-dose narrow-band UVB can be used successfully, in combination with topical treatment, in a 
day care setting to treat psoriatic patients. Since sIL-2R serum levels were not decreased, it can be speculated that 
this treatment does not induce systemic immunosuppression.
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