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UVB-308-nm- (NUVB-)Therapie mittels Excimer-Laser bei atopischer Dermatitis und weiteren inflammatorischen Dermatosen

Targeted UVB-308 nm (NUVB) therapy with excimer laser in the treatment of atopic dermatitis and other inflammatory dermatoses

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Zusammenfassung

UVB-311-nm-Phototherapie (NUVB) wird bei entzündlichen Dermatosen wie der Psoriasis oder der atopischen Dermatitis oft bereits als Therapie der ersten Wahl eingesetzt. In einer prospektiven Studie wurde bei 57 Patienten mit geringer umschriebener therapieresistenter atopischer Dermatitis die Effektivität der gezielten UVB-308-nm-Phototherapie mittels Excimer-Laser untersucht. In durchschnittlich 10 Behandlungen innerhalb 6–8 Wochen konnte bei 85% eine komplette (CR) und bei 15% eine partielle Remission (PR) erzielt werden. Auffällig war ein Sistieren des Pruritus nach nur 3–4 Behandlungen. Anhand der Behandlung von 48 weiteren Patienten mit den Diagnosen Lichen simplex chronicus Vidal, Prurigo nodularis, Granuloma anulare, Alopecia areata und Lichen ruber planus und einer systematischen Literaturrecherche konnte gezeigt werden, dass die gezielte NUVB-Therapie nicht beliebig auf alle umschriebenen inflammatorischen Dermatosen übertragen werden kann. Zufriedenstellende Raten mit CR von 40% und PR von 53% zeigten sich somit nur bei der Alopecia areata sowie dem Lichen ruber mucosa. Die gezielte NUVB-Therapie ist insbesondere bei den chronischen Verläufen der kleinflächigen atopischen Dermatitis eine effektive Erweiterung des therapeutischen Spektrums.

Abstract

UVB 311 nm phototherapy (NUVB) is used successfully in the treatment of psoriasis or atopic dermatitis and is often choosen as “first-line” therapy. In a prospective study we investigated the efficacy of the targeted UVB 308 phototherapy by excimer laser in the treatment of 57 patients with localized, mild therapy-resistant atopic dermatitis. We achieved a complete remission (CR) in nearly 85% and a partial remission (PR) in 15% after 10 treatments during 6–8 weeks in all patients. A mean reduction in patient-reported pruritus was one hallmark after 3–4 treatments. 48 other patients with lichen simplex chronicus Vidal, nodular prurigo, granuloma anulare, alopezia areata (AA) and lichen ruber planus were also treated by targeted NUVB. We found higher rates of CR and PR only in patients with AA and in patients with oral Lichen ruber mucosae. These results and the systematically reviewing of the current medical literature shows that targeted NUVB by excimer laser cannot be successfully transfered for all inflammatory skin diseases. In particular, Excimer UVB treatment expands the therapeutic options in patients with localized and therapy-resistant atopic dermatitis enormously.

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  1. Haut- und Allergieklinik, Klinikum Hanau GmbH, Leimenstr. 20, 63450, Hanau, Deutschland

    I. Wollenschläger, J. Hermann &  H.M. Ockenfels

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  1. I. Wollenschläger
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  2. J. Hermann
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  3. H.M. Ockenfels
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Wollenschläger, I., Hermann, J. & Ockenfels, H. UVB-308-nm- (NUVB-)Therapie mittels Excimer-Laser bei atopischer Dermatitis und weiteren inflammatorischen Dermatosen. Hautarzt 60, 898–906 (2009). https://doi.org/10.1007/s00105-009-1828-8

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