Long-term efficacy of medium-dose UVA1 phototherapy in atopic dermatitis

Background: UVA1 (340-400 nm) therapy proved to be highly effective in pati ents with severe atopic dermatitis. The optimal dose regarding therapeutic efficacy and possible side effects is still to be evaluated. In vitro cell culture as well as in vivo animal studies recently indicated chat a correla tion between UVA irradiation and photoaging, skin carcinogenesis, or melano ma induction may exist. Therefore it seems appropriate to focus research ac tivities on reducing the UVA1 dose applied during phototherapeutic regimens minimizing nonbeneficial side effects. Objective: The present study was performed to evaluate the therapeutic effe ctiveness and long-term efficacy of medium-dose UVA1 irradiation in patient s treated for acute exacerbated atopic dermatitis. Methods: Thirty-two patients underwent a medium-dose UVA1 therapy consistin g of 15 treatments applied From Monday to Friday for a period of 3 weeks. T he applied dose per treatment was 50 J/cm(2) resulting in a cumulative dose of 750 J/cm(2). Clinical severity was assessed according to the SCORAD ind ex before and after irradiation as well as in monthly intervals up to 3 mon ths after cessation of phototherapy. Results: Medium-dose UVA1 phototherapy is effective for alleviating acute e xacerbated atopic dermatitis as shown by a significant reduction of SCORAD ratings (P < .001) at the end of the active UV treatment period. A signific ant skin improvement was still present 1 month later (P < .001). However, a t the end of the month posttreatment observation period the skin condition had reached the pretreatment level. Conclusion: According to our data, medium-dose UVA1 phototherapy is a highl y effective, nonsteroidal, therapeutic alternative for treatment of acute e xacerbated atopic dermatitis. However, effectiveness is merely short term, limited, and is followed by recurrence of symptoms within a 3-month observa tion interval.