Abstract：
BACKGROUND: Ultraviolet (UV) A1 phototherapy is considered a beneficial treatment for various inflammatory, sclerotic, malignant, and other skin conditions. However, the available data regarding its efficacy for different indications, the potential side effects, and the recommended treatment protocols are sparse.
OBJECTIVE: To assess the efficacy of UVA1 phototherapy and identify correlation between different indications and treatment protocols to response rates.
METHODS: We performed a retrospective study of a cohort of 335 patients treated with UVA1 phototherapy at the Department of Dermatology at Hadassah Medical Center, Jerusalem, Israel, between 2008 and 2018.
RESULTS: The study population included 163 patients with inflammatory diseases (mainly atopic dermatitis and other types of eczema), 67 patients with sclerotic diseases (morphea and graft versus host disease), nine patients with neoplastic diseases (cutaneous T cell lymphoma), and 188 patients with other cutaneous disorders. Response rates ranged between 85% and 89% across indications, without differences in response rates among the indication groups (p = .941). In a multivariant logistic regression model, increased number of treatments and higher maximal dosages were associated with response to treatment (p < .001). Using ROC analysis, a cut-off of 8 UVA1 phototherapy treatments was chosen as predictive for beneficial response (86.4% sensitivity, 78% specificity). A cut-off of 40 J/cm2 was chosen as an optimal maximal dosage for differentiating between responders and non-responders (51.1% sensitivity, 83.1% specificity).
CONCLUSIONS: UVA1 phototherapy is an effective treatment for a variety of skin conditions. In most patients, at least eight treatments of a medium-high dosage are required for clinical response.
OBJECTIVE: To assess the efficacy of UVA1 phototherapy and identify correlation between different indications and treatment protocols to response rates.
METHODS: We performed a retrospective study of a cohort of 335 patients treated with UVA1 phototherapy at the Department of Dermatology at Hadassah Medical Center, Jerusalem, Israel, between 2008 and 2018.
RESULTS: The study population included 163 patients with inflammatory diseases (mainly atopic dermatitis and other types of eczema), 67 patients with sclerotic diseases (morphea and graft versus host disease), nine patients with neoplastic diseases (cutaneous T cell lymphoma), and 188 patients with other cutaneous disorders. Response rates ranged between 85% and 89% across indications, without differences in response rates among the indication groups (p = .941). In a multivariant logistic regression model, increased number of treatments and higher maximal dosages were associated with response to treatment (p < .001). Using ROC analysis, a cut-off of 8 UVA1 phototherapy treatments was chosen as predictive for beneficial response (86.4% sensitivity, 78% specificity). A cut-off of 40 J/cm2 was chosen as an optimal maximal dosage for differentiating between responders and non-responders (51.1% sensitivity, 83.1% specificity).
CONCLUSIONS: UVA1 phototherapy is an effective treatment for a variety of skin conditions. In most patients, at least eight treatments of a medium-high dosage are required for clinical response.
摘要：
背景：紫外线（UV）A1光疗被认为是各种炎症的有益治疗方法，硬化,恶性,和其他皮肤状况。然而,关于其对不同适应症的疗效的可用数据，潜在的副作用，推荐的治疗方案很少。
目的：评估UVA1光疗的疗效，并确定不同适应症和治疗方案与反应率之间的相关性。
方法：我们对Hadassah医学中心皮肤科335例接受UVA1光疗的患者进行了回顾性研究，耶路撒冷,以色列,2008年至2018年。
结果：研究人群包括163例炎性疾病患者（主要是特应性皮炎和其他类型的湿疹），67例硬化性疾病患者（角膜和移植物抗宿主病），9例肿瘤疾病（皮肤T细胞淋巴瘤），和188例其他皮肤疾病患者。所有适应症的反应率在85%到89%之间，适应症组之间的应答率没有差异（p=.941）。在多变量逻辑回归模型中，治疗次数增加和最大剂量增加与治疗反应相关(p<.001).使用ROC分析，选择8种UVA1光疗治疗的截止值作为有益反应的预测(86.4%的灵敏度，78%的特异性)。选择40J/cm2的截止值作为区分响应者和非响应者的最佳最大剂量（51.1％的灵敏度，83.1%的特异性)。
结论：UVA1光疗是治疗多种皮肤病的有效方法。在大多数患者中，临床反应需要至少八种中高剂量的治疗。
目的：评估UVA1光疗的疗效，并确定不同适应症和治疗方案与反应率之间的相关性。
方法：我们对Hadassah医学中心皮肤科335例接受UVA1光疗的患者进行了回顾性研究，耶路撒冷,以色列,2008年至2018年。
结果：研究人群包括163例炎性疾病患者（主要是特应性皮炎和其他类型的湿疹），67例硬化性疾病患者（角膜和移植物抗宿主病），9例肿瘤疾病（皮肤T细胞淋巴瘤），和188例其他皮肤疾病患者。所有适应症的反应率在85%到89%之间，适应症组之间的应答率没有差异（p=.941）。在多变量逻辑回归模型中，治疗次数增加和最大剂量增加与治疗反应相关(p<.001).使用ROC分析，选择8种UVA1光疗治疗的截止值作为有益反应的预测(86.4%的灵敏度，78%的特异性)。选择40J/cm2的截止值作为区分响应者和非响应者的最佳最大剂量（51.1％的灵敏度，83.1%的特异性)。
结论：UVA1光疗是治疗多种皮肤病的有效方法。在大多数患者中，临床反应需要至少八种中高剂量的治疗。
