Effect Of NB-UVB Irradiation In Combination With A Small Dose Of Acitretin And Tazarotene0.05%Gel On Severe Plaque Psoriasis

Background: Psoriasis is a kind of chronic relapsing inflammatory disease that mainlymanifests as erythema and scaling and its incidence rate in Han population is about0.123%. There are more than4million psoriasis patients in China, and still getting moreand more in recent years. This disease have serious impact on the patient’s physical andmental health. Plaque psoriasis is the most common type, accounting for more than90%of the total number of patients. The exact pathogenesis of psoriasis is not yet clear.There are several hypothesis of the pathogenesis of psoriasis, such as inheritance,metabolic disorders, infections and immune dysfunction and so on, which may play animportant role in psoriasis attacking. Now we consider that this disease is a complexdisease caused by many factors including inheritance、environment re al.lt is verydiffcult to heal the patient with psoriasis successfully. Although there are a variety ofeffective treatment methods, but among those treatments some are unsatisfactory withobvious side effects, some are too expensive to bear. For the severe plaque psoriasis，it’smore difficult to treat, which may caused a great deal of physical, psychological andeconomic pressure to the patient. Therefore, it is very important to find a way for thetreatment of psoriasis which is safe, effective and has little side effects.Objective: To study the clinical efficacy and safety of using NB-UVB irradiation incombination with a small dose of Acitretin and Tazarotene gel0.05%on severe PluquePsoriosis.and tofind a more effective and less side effects treatment method forpsoriasis. Methods:146patients with severe Plaque Psoriasis were recruited from August2012toNovember2012in the Department of Dermatology, the People’s Hospital of FuyangCity. They were randomly divided into Group A，B and C. Three groups were comparedin the course of the disease, age, stages and psoriasis area and severity index(PASI)score，and there were no signiifcant differences.49patients In Group A (treatmentgroup) were given NB-UVB irradiation three times a week and applied Tazarotene0.05%gel topically once a night; In Group B(Control Group1)，48cases were only givenNB-UVB irradiation three times a week. The other patients in Group C (Control Group2) were only applied Tazarotene0.05%gel topically every night. All the patients weregiven a small dose (0.3-0.5mg/kg.d) of Acitretin. The clinical eiffcacy was evaluated at4weeks and8weeks after treatment respectively. The eiffcacy with multiple groups2rsample pairwise comparison, tes of the three groups were statistically analyzedt bythe SPSS17.0statistical software, and statistical signiifcance was deifned P<0.05has.The recurrence rate was assessed at12weeks after treatment.Results: After8weeks’ treatment, the effective rates of Group A，B and C were93.9%，72.9%and69.4%respectively. The difference between Group A，Group B and Group A，Group C were both statistically signiifcant (P<0.05) and relatively severe side-effectshave not occurred. The recurrence rates in the three groups were16.7%，25.0%，26.7%respectively,and it is obviously lower in Group A than that in Group B and C. The totalcumulative amount of NB-UVB irradiation in Group A and B were11.63J/cm2土3.81J/cm2、16.28J/cm2土4.22J/cm2respectively, and the amount in Group A wassigniifcantly less than that in Group B.Conclusion: The three therapeutic methods for severe plaque psoriasis are all valid,The therapeutic method of NB-UVB irradiation in combination with Tazarotene0.05% gel and small dose of Acitretin showing a high clinical cure rate, low recurrence rate aswell as low adverse effects rate is a safe, effective therapeutic methods for severe plaquepsoriasis which can be used as the conventional clinical treatment methods.