Clinical effectiveness of combined phototherapy in the treatment of patients with atopic dermatitis

Abstract

Background. Due to the insufficient effectiveness of currently known methods of treating patients with atopic dermatitis (ATD), there is a need to find new approaches to solve this problem.

Aims: The study was conducted in order to study the possibility of improving the effectiveness of basic therapy for patients with ATD using combined phototherapy (FT) of narrow-band medium-wave and wide-band long-wave ultraviolet (UV) radiation.

Materials and methods. In a group of 62 patients (average age 24.1 ± 6.1 years), a comparative assessment of the effectiveness of ATD basic drug therapy (BT) and complex treatment using combined FT of narrow-band medium-wave (311 nm) and wide-band long-wave radiation in the range of 320–400 nm was performed.

Results. When using BT and combined FT (CFT) together, there is a potentiation of the clinical effects of the used therapeutic methods. The reduction in the relative risk of the disease recurrence in the СFT + BT group (compared to the BT group) during the year of follow-up was 42%.

Conclusion. The developed method of treatment using combined phototherapy provides a more effective reduction in the severity of skin manifestations of ATD according to the SCORAD index by 34.2% and an improvement in the quality of life by 43.5%, as well as a reduction in the relative risk of the disease recurrence by 42% compared to the results of basic drug therapy.

Keywords

atopic dermatitis / combined phototherapy / quality of life

References

[1] Kubanov AA, Bogdanova EV. Dermatovenereologic health care delivery management in the Russian Federation. Results of 2018. Dermatology and Venereology Bulletin. 2019;95(4):8–23. (In Russ). doi: 10.25208/0042-4609-2019-95-4-8-23

[2] Кубанов А.А., Богданова Е.В. Организация и результаты оказания медицинской помощи по профилю дерматовенерология в Российской Федерации. Итоги 2018 года // Вестник дерматологии и венерологии. 2019. Т. 95. № 4. С. 8–23. doi: 10.25208/0042-4609-2019-95-4-8-23

[3] Psomadakis CE, Han G. New and emerging topical therapies for psoriasis and atopic dermatitis. J Clin Aesthet Dermatol. 2019;12:28–34.

[4] Psomadakis C.E., Han G. New and emerging topical therapies for psoriasis and atopic dermatitis // J Clin Aesthet Dermatol. 2019. Vol. 12, N 12. Р. 28–34.

[5] Kruglova LS. Broadband medium-long-wave phototherapy in the treatment of patients with atopic dermatitis. Bulletin of the Russian State Medical University. 2007;(6):55–62. (In Russ).

[6] Круглова Л.С. Широкополосная средне-длинноволновая фототерапия в лечении больных атопическим дерматитом // Вестник Российского государственного медицинского университета. 2007. № 6. С. 55–62.

[7] Fernández-Guarino M, Aboin-Gonzalez S, Barchino L, et al. Treatment of moderate and severe adult chronic atopic dermatitis with narrow-band UVB and the combination of narrow-band UVB/UVA phototherapy. Dermatol Ther. 2016;29(1):19–23. doi: 10.1111/dth.12273

[8] Fernández-Guarino M., Aboin-Gonzalez S., Barchino L., et al. Treatment of moderate and severe adult chronic atopic dermatitis with narrow-band UVB and the combination of narrow-band UVB/UVA phototherapy. Dermatol Ther. 2016. Vol. 29, N 1. Р. 19–23. doi: 10.1111/dth.12273

[9] Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Dermatol Venereol. 1980;92(1):44–47.

[10] Hanifin J.M., Rajka G. Diagnostic features of atopic dermatitis // Acta Dermatol Venereol. 1980. Suppl. 92. Р. 44–47.

[11] Korostovcev DS, Makarova IV, Revjakina VA, et al. SCORAD Index – an objective and standardized method for assessing skin lesions in atopic dermatitis. Allergology. 2000;(3):39–43. (In Russ).

[12] Коростовцев Д.С., Макарова И.В., Ревякина В.А. и др. Индекс SCORAD — объективный и стандартизованный метод оценки поражения кожи при атопическом дерматите // Аллергология. 2000. № 3. С. 39–43.

[13] Kochergin NG. Osnovnye aspekty patogeneza, kliniki i sovremennoi terapii atopicheskogo dermatita. [dissertation abstract] Moscow; 2001. 30 р. (In Russ).

[14] Кочергин Н.Г. Основные аспекты патогенеза, клиники и современной терапии атопического дерматита: автореф. дис. … докт. мед наук. Москва, 2001. 30 с.

[15] Olisova OYu, Vladimirov VV, Murakhovskaya EK. UVA 370 nm phototherapy of atopic dermatitis. Russian Journal of Skin and Venereal Diseases. 2013;(6):22–27. (In Russ).

[16] Олисова О.Ю., Владимиров В.В., Мураховская Е.К. Фототерапия атопического дерматита УФА-лучами 370 нм // Российский журнал кожных и венерических болезней. 2013. № 6. С. 22–27.

[17] Kosheleva IV, Khasanova AR. Modern therapeutic approaches to atopic dermatitis: the role of phototherapy and the search for new ways. Lechashchii vrach. 2018;(4):24–26. (In Russ).

[18] Кошелева И.В., Хасанова А.Р. Современные терапевтические подходы к атопическому дерматиту: роль фототерапии и поиск новых путей // Лечащий врач. 2018. № 4. С. 24–26.

[19] Оrtiz-Salvador JM, Pérez-Ferriols A. Phototherapy in atopic dermatitis. Adv Exp Med Biol. 2017;996:279–286. doi: 10.1007/978-3-319-56017-5_23

[20] Оrtiz-Salvador J.M., Pérez-Ferriols A. Phototherapy in atopic dermatitis // Adv Exp Med Biol. 2017. Vol. 996. Р. 279–286. doi: 10.1007/978-3-319-56017-5_23

[21] Patrizi A, Raone B, Ravaioli GM. Management of atopic dermatitis: safety and efficacy of phototherapy. Clin Cosmet Investig Dermatol. 2015;8:511–520. doi: 10.2147/CCID.S87987

[22] Patrizi A., Raone B., Ravaioli G.M. Management of atopic dermatitis: safety and efficacy of phototherapy // Clin Cosmet Investig Dermatol. 2015. Vol. 5, N 8. Р. 511–520. doi: 10.2147/CCID.S87987

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