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

近年来，在我们的诊所中，患有严重特应性皮炎的成人患者数量正在增加。10多年来，我们一直用口服8-甲氧基补骨脂素和全身暴露于UVA（全身PUVA治疗）治疗这些患者。在本研究中，我们调查了接受治疗的患者，以建立日本成人重度特应性患者的系统PUVA治疗。患者住院，口服30 mg 8-MOP，随后每周3次用2 × 6 J/cm^2-UVA照射。大多数患者接受了10 - 30次PUVA治疗，总UVA约为100 J/cm ^2。特应性皮炎的严重程度评分线性下降，直到12个治疗，并达到平台之后。未发生不良反应。在接下来的实验中，我们检查了PUVA治疗对特应性皮炎的NC/Nga模型小鼠中自发发展的皮炎的治疗效果。光化学疗法每周3次，共4周。经3次治疗后，皮肤变化开始改善，甚至在PUVA治疗停止后4周也没有复发。总的来说，全身PUVA治疗似乎是治疗严重特应性皮炎的一种有用的方式。

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.