A randomized prospective study of different dose regimens using the 308-nm excimer laser in the treatment of palmoplantar pustulosis
A randomized prospective study of different dose regimens using the 308-nm excimer laser in the treatment of palmoplantar pustulosis
复制标题
308nm准分子激光不同剂量方案治疗掌跖脓疱病的随机前瞻性研究
DOI：
10.1111/dth.15079
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发表时间：
2021-08-09
影响因子：
3.6
通讯作者：
Shi, Yuling
中科院分区：
文献类型：
--
作者：
Peng, Chen;Hu, Yifan;Shi, Yuling
目的：探讨308 nm准分子激光治疗掌跖脓疱病(PPP)的最佳治疗方案。77例PPP患者随机分为低剂量(2倍MED作为初始剂量)、中剂量(4倍MED作为初始剂量)和高剂量组(MED 6倍作为初始剂量)，每个患者的MED取决于个体皮肤对紫外线的敏感度，范围为0.1~0.25J/cm(2)。所有患者均接受308 nm准分子激光治疗，每周3次，共8周。根据掌跖脓疱性银屑病面积和严重程度指数(PP-PASI)和皮肤病生活质量指数(DLQI)进行临床评估。治疗结束时，各治疗组均取得满意疗效，高剂量组PP-PASI评分(16.05+/-4.26)较中、低剂量组(23.67+/-7.16，p<；0.01；22.04+/-5.74，p<；0.01)下降更明显。4周时两组患者DLQI评分改善最大，但高、中剂量组较低剂量组改善更快。红斑、水泡和糜烂的不良反应在高剂量方案中更为常见。大剂量308 nm准分子激光治疗PPP可取得较好疗效，减轻患者病情严重程度，提高患者生活质量。同时，应了解不良反应的发生率，在选择剂量之前有必要对皮肤和皮损类型进行评估。
The objective of this study was to evaluate optimal treatment regimen of 308-nm excimer laser for palmoplantar pustulosis (PPP). 77 patients with PPP were randomly assigned to receive low dose (2-fold of MED as initial dose), medium dose (4-fold of MED as initial dose) and high dose group (6-fold of MED as initial dose) and the MED of each patient depended on the ultraviolet light sensitivity of individual's skin which ranged from 0.1 to 0.25 J/cm(2). All group received 308-nm excimer laser treatment three times weekly for 8 weeks. Clinical evaluation based on the Palmoplantar Pustular Psoriasis Area and Severity Index (PP-PASI) and Dermatology Life Quality Index (DLQI) score. All treatment groups achieved satisfied efficacy at the end of the treatment period with more obvious reduction of PP-PASI score in high dose group (16.05 +/- 4.26) than low and medium dose group (23.67 +/- 7.16, p < 0.01; 22.04 +/- 5.74, p < 0.01). Improvement of DLQI score was greatest at week 4 for all patients in each group, while DLQI improved more quickly in high/medium dose group than low dose group. Adverse effects of erythema, blistering and erosions were more common with the higher dose regimen. High dose of 308-nm excimer laser could achieve a better efficacy in PPP treatment, reduce the severity of the disease in patients and improve the life quality of patients. Meantime, the incidence of adverse reactions should be aware of and it's necessary to evaluate the skin and lesion type before the dose selection.