Abstract
BackgroundTherapy of atopic dermatitis (AD) relies on immunosuppression and/or UV irradiation. Here, we assessed clinical efficacy and histopathological alterations induced by blue light-treatment of AD within an observational, non-interventional study.Methodology/Principal Findings36 patients with severe, chronic AD resisting long term disease control with local corticosteroids were included. Treatment consisted of one cycle of 5 consecutive blue light-irradiations (28.9 J/cm2). Patients were instructed to ask for treatment upon disease exacerbation despite interval therapy with topical corticosteroids. The majority of patients noted first improvements after 2–3 cycles. The EASI score was improved by 41% and 54% after 3 and 6 months, respectively (p≤0.005, and p≤0.002). Significant improvement of pruritus, sleep and life quality was noted especially after 6 months. Also, frequency and intensity of disease exacerbations and the usage of topical corticosteroids was reduced. Finally, immunohistochemistry of skin biopsies obtained at baseline and after 5 and 15 days revealed that, unlike UV light, blue light-treatment did not induce Langerhans cell or T cell depletion from skin.Conclusions/SignificanceBlue light-irradiation may represent a suitable treatment option for AD providing long term control of disease. Future studies with larger patient cohorts within a randomized, placebo-controlled clinical trial are required to confirm this observation.
Highlights
Atopic dermatitis (AD) is a common inflammatory skin disease affecting approximately 10–15% of all individuals in industrialized countries
UV radiation has been shown to be carcinogenic and UV phototherapy is usually not recommended as longterm treatment, and for young and immunosuppressed patients [2,3,4]
Clinical response The clinical activity of atopic dermatitis (AD) was assessed on each visit by a physician
Summary
Atopic dermatitis (AD) is a common inflammatory skin disease affecting approximately 10–15% of all individuals in industrialized countries. The disease severity can range from infrequent, localized skin affections at predeliction sites to acute exacerbation of the entire skin leading to erythrodermia requiring hospitalization. Apart from genetic factors responsible for a predisposition, several alterations of the skin immune system (e.g. differences in the amount of anti-microbial peptides produced by keratinocytes, alterations in the phenotype and function of epidermal dendritic cells with the appearance of normally absent IDEC) and stromal cells (e.g. filaggrin mutation) are important [1]. Acute exacerbation of disease is characterized by a dense infiltrate of the dermis with CD4+ T cells showing a Th2-phenotype. Therapy of atopic dermatitis (AD) relies on immunosuppression and/or UV irradiation. We assessed clinical efficacy and histopathological alterations induced by blue light-treatment of AD within an observational, noninterventional study
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