After 10 treatments, 2 patients had achieved PPPASI 50 and one patient achieved PPPASI 90. After 20 treatments, 9 (50%) of the patients achieved PPPASI 50. At 30 treatments, 9 (60%) of the patients achieved PPPASI 50 and three (20%) achieved PPPASI 90 (Fig. 1b).Mean percentage improvement in PPPASI score was evaluated at every 10 treatments. At 10 treatments, the PPPASI score decreased 30% from baseline, at 20 treatments it had decreased 47% and at 30 treatments it had decreased 55% (Fig. 1c, Table S2). Representative clinical pictures are shown in Fig. S1.The Th17 frequency in the peripheral blood after excimer treatment did not differ significantly from baseline values. In contrast, the Treg frequency increased significantly (P = 0.004; Fig. 2). Th17 levels were significantly correlated with disease duration (r = )0.749), but not the PPPASI score (r = )0.05; Fig. S2).
ConclusionOur results are comparable with those of previous studies (10,11). We used an excimer light with a filter that cuts off wavelengths below 297 nm (2), which seemed to be as effective as other excimer light treatments. Irradiation without wavelengths below 297 nm improves the safety of excimer light treatment.There were no significant changes in Th17 levels after excimer therapy, but the Treg population significantly increased. Treg might better reflect PPP severity than Th17. Th17 levels correlated with the disease duration, which might relate to the pathogenesis in the early stage of this disease.
AcknowledgementsThis work was financially supported by a Grant from the Ministry of Education, Culture, Sports, Science and Technology, Japan. We thank Ms. Nishioka and Ms. Kasuya for technical assistance. T.F, K.T. and A.M. designed the research and analysed the data. E.N and H.K. recruited the patients and collected the data. S.C. monitored statistical data. T.F. and A.M. wrote the manuscript.
Conflict of interestThe authors declare no conflict of interest.
Supporting InformationAdditional Supporting Information may be found in the online version of this article: Figure S1. Clinical pictures of patient No.6 at baseline, and after 10, 20 and 30 treatments. Excimer light was sometimes effective already in the early stages. Figure S2. Relationship between PPPASI, Th17 and disease duration. Th17 levels were not significantly correlated with the PPPASI (r = )0.050), but were significantly correlated with disease duration (r = )0.749). Correlation analyses were performed using the Pearson product-moment correlation coefficient. Table S1. Patient characteristics.