Palmoplantar Dermatozlarda Lokal Psoralen-UVA Tedavisinin Etkinliği ve Güvenliği: Tek Merkezli Retrospektif Bir Çalışma
Öz
Lokal PUVA palmoplantar dermatozlarda dirençli vakalarda kullanılan tedavilerden biridir. Bu çalışmada palmoplantar dermatozların tedavisinde lokal PUVA'nın etkinliğini ve güvenilirliğini değerlendirmeyi amaçladık. Palmoplantar dermatoz (palmoplantar psoriasis, kontakt dermatit, palmoplantar keratoderma, dishidrotik ekzema) tanısıyla lokal PUVA ile tedavi edilen toplam 115 hasta çalışmaya dahil edildi. Ortalama maksimum doz 4.83 ± 2.55 ve ortalama kümülatif UVA dozu 171.30 ± 176.77 idi. Tedavi yanıtı değerlendirildiğinde 58 (%74.35) hastada tam yanıt, 15 (%19.23) hastada kısmi yanıt alınırken, 5 (%6.41) hastada yanıt alınamadı. Gruplar arasında cinsiyet, yaş dağılımı, hastalık süresi, ortalama tedavi süresi, seans sayısı ve tedaviye yanıt açısından hastalıklar arasında anlamlı fark yoktu. En sık görülen yan etki eritemdi ve hastaların 16'sında (%13.9) görüldü. Sonuç olarak lokal PUVA tedavisi palmoplantar dermatozlarda topikal steroid ve sistemik tedavi ihtiyacını azaltan etkili ve güvenli bir tedavi seçeneğidir.
Anahtar Kelimeler
Kaynakça
- 1.Hongal AA, Rajashekhar N, Gejje S. Palmoplantar dermatoses-A clinical study of 300 cases. Journal of clinical and diagnostic research: JCDR. 2016;10(8):WC04.
- 2. Engin B, Oguz O. Evaluation of time‐dependent response to psoralen plus UVA (PUVA) treatment with topical 8‐methoxypsoralen (8‐MOP) gel in palmoplantar dermatoses. Int J Dermatol 2005;44:337-9.
- 3. Riad K, Felix P, Dorit S, Gregory K, Nadim K, Henri T. The use of topical PUVA for palmoplantar dermatoses. J Dermatolog Treat 2006;17:304-7.
- 4. Gençosmanoglu DS. Dermatoloji Pratiğinde Fototerapi Uygulamalarına Güncel Yaklaşım: Bölüm 1. Tarihçe, Lambalar, Ultraviyole Radyasyon Düzeyleri Ölçümü ve Fototerapi Yöntemleri. Turk J Dermatol 2017;11:1-11.
- 5. Akyol M. Fototerapi. Turkderm. 2016;50:15.
- 6. Halpern S, Anstey A, Dawe R, Diffey B, Farr P, Ferguson J, et al. Guidelines for topical PUVA: a report of a workshop of the British photodermatology group. Br J Dermatol 2000;142:22-31.
- 7. Davis MD, McEvoy MT, El-Azhary RA, editors. Topical psoralen-ultraviolet A therapy for palmoplantar dermatoses: experience with 35 consecutive patients. Mayo Clinic Proceedings; 1998: Elsevier.
- 8. Bretterklieber A, Legat FJ, Wolf P, Hofer A. Retrospective long‐term follow‐up in patients with chronic palmoplantar dermatoses after good response to bath PUVA therapy. J Dtsch Dermatol Ges 2012;10:814-8.
- 9. Carrascosa J, Plana A, Ferrándiz C. Effectiveness and safety of psoralen-UVA (PUVA) topical therapy in palmoplantar psoriasis: a report on 48 patients. Actas Dermo-Sifiliográficas (English Edition). 2013;104:418-25.
- 10. Jensen L, Stensgaard A, Andersen KE. Psoralen plus ultraviolet A (PUVA) soaks and UVB TL01 treatment for chronic hand dermatoses. Dermatol Reports 2012;4:e3.
- 11. Ibbotson SH. A Perspective on the Use of NB-UVB Phototherapy vs. PUVA Photochemotherapy. Frontiers in medicine. 2018;5:184.
- 12. Raposo I, Torres T. Palmoplantar psoriasis and palmoplantar pustulosis: current treatment and future prospects. Am J Clin Dermatol 2016;17:349-58.
Efficacy and Safety of Local Psoralen-UVA Treatment in Palmoplantar Dermatoses: A Single-Center Retrospective Study
Öz
Local PUVA is one of the treatments used for resistant cases in palmoplantar dermatoses. In this study, we aimed to evaluate the efficacy and safety of local PUVA in the treatment of palmoplantar dermatoses. A total of 115 patients who were treated with local PUVA with the diagnosis of palmoplantar dermatosis (palmoplantar psoriasis, contact dermatitis, palmoplantar keratoderma, dyshidrotic eczema) were included in the study. The mean maximum single dose was 4.83 ± 2.55 and the mean cumulative UVA dose was 171.30 ± 176.77. Treatment response was evaluated in 78 (67.8%) of the patients; 37 (32.2%) patients were lost to follow up. When the treatment response was evaluated, 58 (74.35%) patients achieved a complete response; 15 (19.23%) patients achieved a partial response, and 5 (6.41%) patients had no response to the treatment. There was no significant difference between diseases in terms of gender and age distribution, disease duration, mean duration of treatment, number of sessions and response to treatment between groups. Erythema was the most common adverse effect and was observed in 16 (13.9%) of the patients. In conclusion, local PUVA treatment is an effective and safe treatment option in palmoplantar dermatoses that reduces the need for topical steroids and other systemic treatments.
Anahtar Kelimeler
Kaynakça
- 1.Hongal AA, Rajashekhar N, Gejje S. Palmoplantar dermatoses-A clinical study of 300 cases. Journal of clinical and diagnostic research: JCDR. 2016;10(8):WC04.
- 2. Engin B, Oguz O. Evaluation of time‐dependent response to psoralen plus UVA (PUVA) treatment with topical 8‐methoxypsoralen (8‐MOP) gel in palmoplantar dermatoses. Int J Dermatol 2005;44:337-9.
- 3. Riad K, Felix P, Dorit S, Gregory K, Nadim K, Henri T. The use of topical PUVA for palmoplantar dermatoses. J Dermatolog Treat 2006;17:304-7.
- 4. Gençosmanoglu DS. Dermatoloji Pratiğinde Fototerapi Uygulamalarına Güncel Yaklaşım: Bölüm 1. Tarihçe, Lambalar, Ultraviyole Radyasyon Düzeyleri Ölçümü ve Fototerapi Yöntemleri. Turk J Dermatol 2017;11:1-11.
- 5. Akyol M. Fototerapi. Turkderm. 2016;50:15.
- 6. Halpern S, Anstey A, Dawe R, Diffey B, Farr P, Ferguson J, et al. Guidelines for topical PUVA: a report of a workshop of the British photodermatology group. Br J Dermatol 2000;142:22-31.
- 7. Davis MD, McEvoy MT, El-Azhary RA, editors. Topical psoralen-ultraviolet A therapy for palmoplantar dermatoses: experience with 35 consecutive patients. Mayo Clinic Proceedings; 1998: Elsevier.
- 8. Bretterklieber A, Legat FJ, Wolf P, Hofer A. Retrospective long‐term follow‐up in patients with chronic palmoplantar dermatoses after good response to bath PUVA therapy. J Dtsch Dermatol Ges 2012;10:814-8.
- 9. Carrascosa J, Plana A, Ferrándiz C. Effectiveness and safety of psoralen-UVA (PUVA) topical therapy in palmoplantar psoriasis: a report on 48 patients. Actas Dermo-Sifiliográficas (English Edition). 2013;104:418-25.
- 10. Jensen L, Stensgaard A, Andersen KE. Psoralen plus ultraviolet A (PUVA) soaks and UVB TL01 treatment for chronic hand dermatoses. Dermatol Reports 2012;4:e3.
- 11. Ibbotson SH. A Perspective on the Use of NB-UVB Phototherapy vs. PUVA Photochemotherapy. Frontiers in medicine. 2018;5:184.
- 12. Raposo I, Torres T. Palmoplantar psoriasis and palmoplantar pustulosis: current treatment and future prospects. Am J Clin Dermatol 2016;17:349-58.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Dermatoloji |
| Bölüm | ORİJİNAL MAKALELER / ORIGINAL ARTICLES |
| Yazarlar | |
| Yayımlanma Tarihi | 16 Ocak 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 46 Sayı: 1 |