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High-dose UVA1 therapy for atopic dermatitis: results of a multicenter trial.

BACKGROUND: The results of an open, single-center study suggested that phototherapy with high doses of UVA1 radiation (UVA1R; 340-400 nm) is effective for acute, severe exacerbations of atopic dermatitis (AD). OBJECTIVE: The purpose of this study was to assess the effectiveness of high-dose UVA1 phototherapy for acute, severe AD in a randomized multicenter trial in direct comparison with topical glucocorticoid therapy. METHODS: Patients were treated with high-dose UVA1R (10 days, 130 J/cm2/day; n = 20), topically with fluocortolone (10 days, 1 x daily; n = 17), or with UVA-UVB therapy (10 days, 1 x daily, minimal erythema dose-dependent; n = 16). RESULTS: With a clinical scoring system, significant differences in favor of high-dose UVA1R and fluocortolone therapy were observed (p < 0.0001), as compared with UVA-UVB therapy. At day 10, high-dose UVA1R was superior to fluocortolone (p < 0.002) therapy. Serum levels of eosinophil cationic protein and the blood eosinophil count were significantly reduced after high-dose UVA1 or fluocortolone, but not UVA-UVB therapy. CONCLUSION: This study confirms the therapeutic effectiveness of high-dose UVA1 monotherapy for treatment of severe exacerbations of AD.

Administration, Topical↗

Effect of corticosteroids on intraocular pressure, ascorbic acid and sialic acid concentrations in aqueous humour and on mucopolysaccharides biosynthesis in the cornea of rabbits.

The effect of daily oral administration of corticosteroids on ocular dynamics and biosynthesis of corneal mucopolysaccharides was investigated using rabbits as experimental animals. Fluocortolone treatment at doses of 0.05 to 10 mg/kg resulted in a dose-dependent rise of intraocular pressure (IOP). At higher dose levels of 5 and 10 mg fluocortolonel kg daily over 14 days, an inhibition of 35S-incorporation and a reduction in the nexosamine content of the corneal mucopolysaccharides was observed. When the effects of prednisolone, fluocortolone and dexamethasone on IOP were compared the relative order of the potency for the corticosteroids was as follows: dexamethasone > fluocortolone > prednisolone. The influence of different doses of fluocortolone on ascorbic and sialic acid content in aqueous humour and plasma was also studied. Levels of 5 and 10 mg/kg caused a significant reduction of ascorbic acid and a slight increase in sialic acid content in aqueous humor besides an elevation of IOP, whereas the plasma levels of both components did not reveal any difference from control group. These findings suggest that the blood-aqueous barrier becomes more permeable under the treatment with corticosteroids, especially in doses which are known to be toxic in animals. Further, the rabbit can be used as an experimental animal for comparing the effets of different corticosteroids on IOP.

Animals↗