The Treatment of Atopic Dermatitis with PUVA Photochemotherapy : Clinical and Experimental Studies in Patients and Model Mice

近年来，成人重症特应性皮炎患者数量呈上升趋势。10多年来，我们一直使用口服8-甲氧补骨脂素和全身暴露于UVA(全身PUVA疗法)来治疗这些患者。在本研究中，我们对接受治疗的患者进行了调查，以建立日本成人重度特应性患者的系统PUVA治疗。入院后给予8-MOP 30 mg口服，然后用2~6J/cm~2-UVA照射，每周3次。大多数患者接受了10~30次的PUVA治疗，总共接受了大约100J/cm2的UVA治疗。特应性皮炎的严重程度评分在12次治疗前呈线性下降，此后达到平台期。未见不良反应。在接下来的实验中，我们研究了PUVA治疗对NC/NGA特应性皮炎模型小鼠自发性皮炎的治疗效果。光化学治疗每周3次，共4周。经过3次治疗，皮肤变化开始改善，甚至在停止PUVA治疗4周后也没有复发。总体而言，全身PUVA疗法似乎是治疗严重特应性皮炎的一种有效方法。

Recently, the number of adult patients with severe atopic dermatitis is increasing in our clinic. For more than 10 years, we have treated these patients with oral 8-methoxypsoralen and whole body exposures to UVA (systemic PUVA therapy). In the present study, we surveyed the treated patients in order to establish the systemic PUVA therapy in Japanese adult patients with severe atopic patients. Patients were hospitalized, and given orally 30mg of 8-MOP and subsequently irradiated with 2〜6J/cm^2-UVA three times a week. Most of patients received 10 to 30 time-PUVA therapy and approximately 100 J/cm^2 of UVA in total. Severity scores of atopic dermatitis linearly decreased until 12 treatments, and reached plateau thereafter. No adverse effects occurred. In next experiments, we examined the therapeutic effects of PUVA treatment on the spontaneously developed dermatitis in NC/Nga model mice of atopic dermatitis. Photochemotherapy was done 3 times a week for 4 weeks. Skin changes began to improve by 3 treatments, and did not recur even 4 weeks after discontinuation of PUVA therapy. Collectively, systemic PUVA therapy seems to be a useful modality for the treatment of severe atopic dermatitis.