UVA-1 cold light therapy in the treatment of atopic dermatitis: 61 patients treated in the Leiden University Medical Center

Background: UVA-1 has been shown to be effective in the treatment of patients with atopic dermatitis. However, its optimal therapeutic conditions are not yet fully established. Methods: In an open prospective study we retrospectively compared the effect of 4 weeks therapy (32 patients) with the effect of the usual 3 weeks therapy (29 patients) in patients with atopic dermatitis, using a medium dose UVA-1 cold light (45 J/cm(2)), 5 days a week. Results: Scoring atopic dermatitis index (SCORAD) and dermatology life quality index (DLQI) quality of life indexes improved significantly during both 3 and 4 weeks UVA-1. Patients who were treated for 4 weeks showed a superior improvement of the SCORAD index [23.12 points, 95% confidence interval (CI) 16.09-30.16, vs. 13.32 points, 95% CI 5.61-21.04, P=0.059], and the DLQI (5.41 points, 95% CI 2.38-7.88, vs. 3.86 points, 95% CI 1.88-5.84, P=0.360), compared with patients who were treated for 3 weeks. However, the differences did not reach statistical significance. Only patients who were treated for 4 weeks were able to maintain their improvement 6 weeks after therapy. In both groups 50% of patients had intermittently used mild topical corticosteroids in the follow-up period. Conclusion: Extension of UVA-1 therapy from 3 to 4 weeks results in a clinically relevant improvement of the outcome, and more prolonged therapeutic effects, measured by the SCORAD index.