Vitiligo is a common, acquired pigmentary disorder of unknown etiology with great impact on patient's appearance and quality of life. It presents a therapeutic challenge to many dermatologists. Photochemotherapy u...Vitiligo is a common, acquired pigmentary disorder of unknown etiology with great impact on patient's appearance and quality of life. It presents a therapeutic challenge to many dermatologists. Photochemotherapy using psoralen and ultraviolet A(UVA) therapy, topical and oral immunosuppresants, as well as cosmetic camouflage are also commonly employed with varying clinical efficacy. Phototherapy is a popular treatment option, which includes both of the generalized ultraviolet B(UVB) therapies, broadband UVB and narrowband UVB(NB-UVB). It has been used favorably, both alone as well as in combination with other agents like topical calcineurin inhibitors, vitamin-D analogs. Combination therapies are useful and may provide quicker regimentation and treat vitiligo with an additive mechanism of action than UVB phototherapy. Advances in technology may lead to the continuing use of UVB phototherapy as a treatment for vitiligo through the development of sophisticated devices and delivery systems as well as innovative application methods. These will provide increased therapeutic options for all vitiligo patients, particularly those with refractory disease. In this article, I have reviewed the available data pertaining to efficacy and safety issues for NB-UVB as monotherapy, its comparison with psoralen plus UVA and other modes of phototherapy, combination regimens that have been tried and future prospects of NB-UVB in vitiligo.展开更多
目的探讨窄谱中波紫外线(NB-UVB)家庭光疗与院内光疗治疗小腿斑块状银屑病的疗效比较。方法选择2018年7月至2020年6月嘉兴市第一医院皮肤科门诊收治的58例小腿斑块状银屑病患者,随机分为对照组28例和观察组30例收治的对照组给予外用卡...目的探讨窄谱中波紫外线(NB-UVB)家庭光疗与院内光疗治疗小腿斑块状银屑病的疗效比较。方法选择2018年7月至2020年6月嘉兴市第一医院皮肤科门诊收治的58例小腿斑块状银屑病患者,随机分为对照组28例和观察组30例收治的对照组给予外用卡泊三醇倍他米松软膏联合院内照射NB-UVB,观察组给予外用卡泊三醇倍他米松软膏联合家中自行照射NB-UVB,两组疗程均为8周。通过治疗前后银屑病皮损面积与严重程度指数(psoriasis area and severity index,PASI)评分判定疗效,记录皮肤不良反应发生情况,以调查问卷形式评价便利性。结果治疗后两组的PASI评分均较治疗前下降,差异有统计学意义(P<0.05);治疗后两组的PASI评分比较,差异无统计学意义(P>0.05)。对照组的总有效率为82.14%,观察组为76.67%,两组比较,差异无统计学意义(P>0.05)。对照组的轻度皮肤不良反应发生率为17.86%,观察组为13.33%,两组比较,差异无统计学意义(P>0.05)。观察组的便利性优于对照组,差异有统计学意义(P<0.05)。结论NB-UVB家庭光疗对比院内光疗治疗小腿斑块状银屑病,疗效相当,安全性良好,便利程度高,值得临床推广。展开更多
Objective:To study the changes of HSPs family expression in psoriasis lesions and their correlation with inflammatory response before and after narrow-band ultraviolet B (NB-UVB) treatment.Methods: Patients who were n...Objective:To study the changes of HSPs family expression in psoriasis lesions and their correlation with inflammatory response before and after narrow-band ultraviolet B (NB-UVB) treatment.Methods: Patients who were newly diagnosed with psoriasis vulgaris and treated in Dermatology Department of our hospital between March 2015 and May 2017 were selected and randomly divided into the NB-UVB group who received NB-UVB combined with conventional treatment and the control group who received conventional treatment. Before treatment and 20 d after treatment, proper amount of psoriasis lesion was collected to determine the expression of HSPs family molecules and lymphocyte transcription factors as well as the levels of inflammatory cytokines.Results: Compared with those before treatment, HSP27, HSP60, HSP90 , HSP90β, T-bet and Foxp3 mRNA expression as well as MCP-1, IFN-γ and IL-17 levels in psoriasis lesion of both groups significantly decreased whereas GATA-3 and RORγt mRNA expression as well as IL-10 and TGF-β1 levels significantly increased after treatment, and HSP27, HSP60, HSP90 , HSP90β, T-bet and Foxp3 mRNA expression as well as MCP-1, IFN-γ and IL-17 levels in psoriasis lesion of NB-UVB group were significantly lower than those of control group whereas GATA-3 and RORγt mRNA expression as well as IL-10 and TGF-β1 levels were significantly higher than those of control group;HSP27, HSP60, HSP90 and HSP90β mRNA expression in psoriasis lesion of NB-UVB group after treatment were positively correlated with MCP-1, IFN-γ and IL-17 levels as well as T-bet and Foxp3 mRNA expression, and negatively correlated with IL-10 and TGF-β1 levels as well as GATA-3 and RORγt mRNA expression.Conclusion: NB-UVB treatment of psoriasis can reduce the expression of HSPs family members and inhibit the inflammatory response mediated by HSPs.展开更多
文摘Vitiligo is a common, acquired pigmentary disorder of unknown etiology with great impact on patient's appearance and quality of life. It presents a therapeutic challenge to many dermatologists. Photochemotherapy using psoralen and ultraviolet A(UVA) therapy, topical and oral immunosuppresants, as well as cosmetic camouflage are also commonly employed with varying clinical efficacy. Phototherapy is a popular treatment option, which includes both of the generalized ultraviolet B(UVB) therapies, broadband UVB and narrowband UVB(NB-UVB). It has been used favorably, both alone as well as in combination with other agents like topical calcineurin inhibitors, vitamin-D analogs. Combination therapies are useful and may provide quicker regimentation and treat vitiligo with an additive mechanism of action than UVB phototherapy. Advances in technology may lead to the continuing use of UVB phototherapy as a treatment for vitiligo through the development of sophisticated devices and delivery systems as well as innovative application methods. These will provide increased therapeutic options for all vitiligo patients, particularly those with refractory disease. In this article, I have reviewed the available data pertaining to efficacy and safety issues for NB-UVB as monotherapy, its comparison with psoralen plus UVA and other modes of phototherapy, combination regimens that have been tried and future prospects of NB-UVB in vitiligo.
文摘目的探讨窄谱中波紫外线(NB-UVB)家庭光疗与院内光疗治疗小腿斑块状银屑病的疗效比较。方法选择2018年7月至2020年6月嘉兴市第一医院皮肤科门诊收治的58例小腿斑块状银屑病患者,随机分为对照组28例和观察组30例收治的对照组给予外用卡泊三醇倍他米松软膏联合院内照射NB-UVB,观察组给予外用卡泊三醇倍他米松软膏联合家中自行照射NB-UVB,两组疗程均为8周。通过治疗前后银屑病皮损面积与严重程度指数(psoriasis area and severity index,PASI)评分判定疗效,记录皮肤不良反应发生情况,以调查问卷形式评价便利性。结果治疗后两组的PASI评分均较治疗前下降,差异有统计学意义(P<0.05);治疗后两组的PASI评分比较,差异无统计学意义(P>0.05)。对照组的总有效率为82.14%,观察组为76.67%,两组比较,差异无统计学意义(P>0.05)。对照组的轻度皮肤不良反应发生率为17.86%,观察组为13.33%,两组比较,差异无统计学意义(P>0.05)。观察组的便利性优于对照组,差异有统计学意义(P<0.05)。结论NB-UVB家庭光疗对比院内光疗治疗小腿斑块状银屑病,疗效相当,安全性良好,便利程度高,值得临床推广。
文摘Objective:To study the changes of HSPs family expression in psoriasis lesions and their correlation with inflammatory response before and after narrow-band ultraviolet B (NB-UVB) treatment.Methods: Patients who were newly diagnosed with psoriasis vulgaris and treated in Dermatology Department of our hospital between March 2015 and May 2017 were selected and randomly divided into the NB-UVB group who received NB-UVB combined with conventional treatment and the control group who received conventional treatment. Before treatment and 20 d after treatment, proper amount of psoriasis lesion was collected to determine the expression of HSPs family molecules and lymphocyte transcription factors as well as the levels of inflammatory cytokines.Results: Compared with those before treatment, HSP27, HSP60, HSP90 , HSP90β, T-bet and Foxp3 mRNA expression as well as MCP-1, IFN-γ and IL-17 levels in psoriasis lesion of both groups significantly decreased whereas GATA-3 and RORγt mRNA expression as well as IL-10 and TGF-β1 levels significantly increased after treatment, and HSP27, HSP60, HSP90 , HSP90β, T-bet and Foxp3 mRNA expression as well as MCP-1, IFN-γ and IL-17 levels in psoriasis lesion of NB-UVB group were significantly lower than those of control group whereas GATA-3 and RORγt mRNA expression as well as IL-10 and TGF-β1 levels were significantly higher than those of control group;HSP27, HSP60, HSP90 and HSP90β mRNA expression in psoriasis lesion of NB-UVB group after treatment were positively correlated with MCP-1, IFN-γ and IL-17 levels as well as T-bet and Foxp3 mRNA expression, and negatively correlated with IL-10 and TGF-β1 levels as well as GATA-3 and RORγt mRNA expression.Conclusion: NB-UVB treatment of psoriasis can reduce the expression of HSPs family members and inhibit the inflammatory response mediated by HSPs.
