Background: Extracorporeal photochemotherapy (ECP) using UVA irradiation of
enriched leukocytes in the presence of methoxsalen as a photoactivatable s
ubstrate has been employed for the treatment of several immunologically med
iated disorders.
Objective: Our purpose was to determine the efficacy and safety of long-ter
m ECP in the treatment of severe atopic dermatitis.
Methods: Fourteen patients with severe recalcitrant atopic dermatitis were
treated with ECP in an open clinical trial at 2-week intervals. Disease act
ivity was scored before each ECP cycle by means of a standardized protocol.
Results: A complete clinical remission was achieved in 4 patients (29%). Fi
ve patients (36%) experienced a substantial response with reduction of skin
inflammation by at least 75%, whereas in one patient (7%) disease activity
was reduced by more than 50%. Four patients were withdrawn from the study
for unresponsiveness. No clinical signs of immunosuppression or other sever
e adverse events became evident.
Conclusion: Long-term ECP may have significant beneficial effects on the co
urse of atopic dermatitis and should therefore be considered as a treatment
modality for patients suffering from severe and otherwise refractory atopi
c skin disease.