| Background: Palmoplantar pustulosis(PPP)is a chronic and recurrent skin disease,which the aseptic pustules on the erythema and scales with hyperkeratosis limited to mainly characterized by palmoplantar[1].At present,the etiology and pathogenesis of palmoplantar pustulosis remains unclear.It has been proved that infection focus,metal sensitization and stimulation of external factors,endocrine diseases can induce and aggravate the occurrence and development of the disease.Treatment of palmoplantar pustulosis at present about the systemic drugs mainly depends on retinoic acid such as AVI A,methotrexate,colchicine and so on.But considering the many adverse reaction system of oral drugs,such as AVI A can lead to liver damage,dyslipidemia and teratogenicity,dry skin mucosa.Methotrexate can cause bone marrow suppression,gastrointestinal reaction,liver toxicity and carcinogenicity.Most of the scholars recognised of its effect at the same time because of their side effects discouraged.Therefore,more and more attention has been paid to local treatment.The local treatment of palmoplantar pustulosis include medications such as corticosteroids,vitamin A acid ointment ointment,physical therapy mainly include UVA,UVB,photochemotherapy and so on.However,long-term use of glucocorticoids can appear skin atrophy,telangiectasia and other side effects;UV light prone to pigmentation,dry skin.Photochemotherapy has been widely accepted as a safe treatment modality in many treatments.Photochemotherapy is a method of treatment of internal or external use of photosensitizer UVA irradiation,photosensitizer is mainly chemical constituents extracted from Chinese herbal medicine Psoralea corylifolia,such as 8-Methoxypsoralen(8-methoxypsoralen,8-MOP),isopsoralen and so on.Because of the photosensitizer types and using methods,considering the adverse reactions and clinical aspects of operability,the popular method is using psoralen tincture 30 min and then UVA irradiation.Because of psoralen can be extracted a variety of photosensitive chemical composition,so this research tries to use pure herbs soaked in ethanol PsoraleaCorylifolia after 3 weeks of the 30 min coating the solution of local lesions were treated with UVA,and observe the clinical curative effect.Objective: Observe the effective,safety and treatment of recurrent of palmoplantar pustulosis treated by photochemotherapy which is combined with Psoralea Corylifoliatincture and UVA(photochemotherapy),and then provide reference for clinical application.Method: 1.Using epidemiological investigation,we collected 20 cases of clinical data of patients with palmoplantar pustulosis outpatient treatment in our department from September 2014 to January 2017 in our hospital.2.20 patients were only treated with photochemotherapy local illumination,the initial dose of 0.5J/cm2,3 times / week,the highest dose of 15J/cm2,after reaching the highest dose,if not cured,then maintain the dose to continue treatment.3.the skin lesions and adverse reactions of the 20 patients before and after irradiation for 4 weeks and 8 weeks were observed,then followed up the recurrence rate,and the PASI score was calculated before and after treatment,and calculate the effective rate.Results: In the 20 cases,3 cases were cured(15%),1 cases(5%)obviously effective,8 cases(40%)effective,and invalid in 8 cases(40%);the total efficiency of60%.20 PPP patients presented with pigmentation,dry skin.Mild pruritus and erythema in 3 cases.1 case of 3 patients recovered in the follow-up appeared small area recurrence.Conclusion: : the use of psoralen photochemical therapy in the treatment of palmoplantar pustulosis have certain effect,can improve the main clinical symptoms,and long-term use without obvious local and systemic side effects,high safety index. |
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