Atopic Eczema
Conditions
Keywords
eczema, phototherapy, uva1, uvb, adults, children
Brief summary
Narrowband ultraviolet B phototherapy is the standard phototherapy for atopic eczema; ultraviolet A1 is sometimes used but is not a widely available treatment. We do not know the most important chromophores in treating atopic eczema; in which phototherapy is thought to work by improving epidermal barrier function, having beneficial effects on skin microbiome and local immunosuppression. It seems plausible that there are several chromophores and that 'targetting' several at once with different wavebands should help and for severe eczema that has not responded adequately to narrowband UVB or ultraviolet A1 alone the combination is sometimes used. This study is to test if the combination is moderately to greatly more effective than narrowband ultraviolet B monotherapy amongst patients referred for any form of first-line phototherapy for atopic eczema.
Detailed description
Narrowband ultraviolet B phototherapy is the standard phototherapy widely used for atopic eczema; ultraviolet A1 is sometimes used but is not a widely available treatment. We do not know the most important chromophores in treating atopic eczema; in which phototherapy is thought to work by improving epidermal barrier function, having beneficial effects on skin microbiome and local immunosuppression. It seems plausible that there are several chromophores (the molecules that absorb the ultraviolet photons to set in chain the effects we are aiming for) and that 'targetting' several chromophores at once with different wavebands should help. For severe eczema that has not responded adequately to narrowband UVB or ultraviolet A1 alone the combination is sometimes used in the few centres where UVA1 is available. This study is to test if the combination is moderately to greatly more effective than narrowband ultraviolet B monotherapy amongst patients referred for any form of first-line phototherapy for atopic eczema.
Interventions
RADIATIONcombined ultraviolet phototherapy (NB-UVB + UVA1) vs. NB-UVB monotherapy
NB-UVB combined with UVA1
Sponsors
NHS Tayside
University of Dundee
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
12 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients with atopic eczema as diagnosed by a dermatologist, defined according to the UK Working Party diagnostic criteria, considered for any form of whole body phototherapy * Age 12 years and above * Able to understand and comply with protocol requirements and treatment visits, instructions and protocol stated restrictions * Provision of written informed consent in accordance with the Scottish Children's Network consent guidance and standard operating procedure (SOP) for subjects aged 12-15 years * Provision of written informed consent (subjects age 16 years and over)
Exclusion criteria
* Unable to provide written informed consent in accordance with the Scottish Children's Network consent guidance and SOP * Unable to provide written informed consent (subjects age 16 years and over) * Currently being treated, or treated within the past 2 weeks, with systemic immunosuppressive therapy * Current use of drugs known to cause photosensitivity * Phototherapy, photochemotherapy, or sunbed use in the preceding 3 months * Known abnormal photosensitivity * Previous history of skin cancer * Participation in another research study within the past three months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in EASI (eczema severity score) - proportions reaching 50% reduction | From beginning to end of treatment (25 weeks) | observer-assessed eczema severity |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| POEM (patient orientated eczema measure) | 26 weeks after treatment completion | patient-assessed eczema severity |
Countries
United Kingdom
Outcome results
None listed