Phototherapy in the management of atopic dermatitis: a systematic review

Abstract

Background/purpose: Atopic dermatitis (AD) is a common and extremely burdensome skin disorder with limited therapeutic options. Ultraviolet (UV) phototherapy is a well tolerated, efficacious treatment for AD, but its use is limited by a lack of guidelines in the optimal choice of modality and dosing. Given this deficit, we aim to develop suggestions for the treatment of AD with phototherapy by systematically reviewing the current medical literature. Methods: Data sources: All data sources were identified through searches of MEDLINE via the Ovid interface, the Cochrane Central Register of Controlled Trials, and a complementary manual literature search. Study selection: Studies selected for review met these inclusion criteria, as applied by multiple reviewers: controlled clinical trials of UV phototherapy in the management of AD in human subjects as reported in the English-language literature. Studies limited to hand dermatitis and studies in which subjects were allowed unmonitored use of topical corticosteroids or immunomodulators were excluded. Data extraction: Included studies were assessed by multiple independent observers who extracted and

Therapeutic Benefits in Atopic Dermatitis Care from the Patients' Perspective: Results of the German National Health Care Study ‘Atopic Health'

“…Various phototherapy modalities such as narrow-band UVB, UVA1 or UVA/UVB therapy are common treatment regimens of atopic dermatitis [38,39,40,41]. As the DLQI or the EQ-5D-VAS have not been used for evaluating UV therapy in atopic dermatitis patients yet, comparison of the present results is difficult [42].…”

Cataracts in Atopic Dermatitis

“…The newer narrowband UV-B and UV-A1 are considered the most efficacious regimens for treating acute and chronic AD. 19,20 Exposure of the unprotected eye to psoralen plus UV-A (PUVA) therapy has been shown to induce cortical lens opacities. 19 Cortical cataracts are structurally different than anterior or posterior subcapsular cataracts seen with AD and are strongly associated with UV radiation.…”

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

“…Auch bei der atopischen Dermatitis konnte inzwischen die abheilende Wirkung einer NUVB-Ganzkörperbestrah-lung mehrfach in prospektiven und randomisierten Studien nachgewiesen werden [5,22]. Neben der akut antiinflammatorischen Wirkung konnten Reynolds et al [26] zudem 3 Monate nach Abschluss der Phototherapie noch fast 40% höhere Abheilungsraten nach NUVB als in den Gruppen mit UVA1 oder sichtbarem Licht darstellen.…”

“…Je nach Schweregrad und Ausbreitung der Hauterkrankung sind UVPhototherapien als "First-line-Therapien" etabliert, insbesondere dort, wo glukokortikoidhaltige Externa lediglich einen morbusstatischen, nicht aber einen kurativen Effekt ausüben [6,11,22]. Indikationslimitierend für den Einsatz von Phototherapien war in der Vergangenheit eine kleinflächige Ausbreitung der Erkrankung über die Körperoberfläche von <10 bis <20% [5,21].…”