Aktuelle UV-Therapie der Psoriasis

Zusammenfassung

In der Behandlung der Psoriasis hat die Photo- und Photochemotherapie nach wie vor einen hohen Stellenwert. Die Schmalspektrum-UV-B-Phototherapie mit einem Emissionsmaximum von 311 ± 2 nm hat die Breitspektrum-UV-B-Therapie (280 - 320 nm) weitgehend abgelöst. Hinsichtlich Effektivität, Nutzen-Risikoprofil und Kosten gilt die Schmalspektrum-UV-B-Therapie als Phototherapie der ersten Wahl bei mittelschwerer bis schwerer Psoriasis. Kombinationstherapien mit topischen oder systemischen Medikamenten können die UV-B-Phototherapie effektiver und sicherer machen. Durch die bessere Verträglichkeit gegenüber der oralen PUVA-Therapie gewinnt aber auch die Bade-PUVA-Therapie bei schweren Formen der Psoriasis zunehmend an Bedeutung, insbesondere zur lokalisierten Behandlung der häufig therapieresistenten Psoriasis palmoplantaris.

Abstract

Photo- und photochemotherapy are widely used and highly effective therapy modalities for psoriasis. Narrow-band phototherapy with fluorescence bulbs emitting UV-radiation with a peak at 311 ± 2 nm, is considered to be superior to conventional broad-band UV-B (280 - 320 nm). With respect to efficacy, benefit-risk-profile and costs, narrow-band UV-B phototherapy is the first-line UV-treatment for moderate to severe psoriasis. Moreover, combination therapies with topical or systemic drugs have been shown to enhance clinical efficacy and safety. Still, due to marked reduction of adverse effects as compared to systemic PUVA, topical PUVA (bath or creme) has become an important treatment modality for severe as well as localized palmoplantar psoriasis.

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