Effects Of Desonide Cream In Combination With Narrow-band Ultraviolet B In Atopic Dermatitis And The Study Of Its Associated Immune Factors

Objective: To observe the clinical efficacy of Desonide cream combined with narrow-band ultraviolet B(NB-UVB)in the treatment of atopic dermatitis,and to determine the serum IL-17 A and IL-23 levels in AD patients before and after treatment to explore their correlation with AD condition.Methods: From October 2018 to October 2020,60 patients with AD and 60 volunteers with health check-ups at the outpatient clinic of the First Affiliated Hospital of Hebei North University were selected.The serum IL-17 A and IL-23 levels of AD patients and health check-up volunteers were measured by ELISA.Group A was treated with topical0.05% Desonide cream(twice a day for four weeks),Group B was treated with NB-UVB irradiation(the initial dose is 70% of minimal erythema dose and the next dose is adjusted according to the response after each exposure,three times a week for four weeks)and Group C was treated with 0.05% Desonide cream(twice a day for four weeks)in combination with NB-UVB irradiation(the initial dose selection and adjustment method is the same as group B,three times a week for four weeks).The group whose intervention included desonide cream was instructed to individualize its dosing according to the glucocorticoid fingertip unit,and subjects in Group C were instructed to avoid applying the cream within 2hours prior to NB-UVB irradiation treatment.Measurement of peripheral serum IL-17 A and IL-23 levels in AD patients after treatment.The disease was assessed using the European SCORAD scoring system(with VAS score).IL-17 A and IL-23 levels were compared between AD patients before treatment and normal controls,and the clinical efficacy,SCORAD and VAS scores and changes in IL-17 A and IL-23 concentrations were compared between the three treatment regimens.SPSS 26.0 software was used for data collation and statistical analysis.Results: Among the AD patients,group A included 4 mild cases and16 moderate cases,group B included 3 mild cases and 17 moderate cases,and group C included 1 mild case and 19 moderate cases.Comparing the general data of the three groups,P>0.05,and the difference was not statistically significant.After 4 weeks of treatment,SCORAD and VAS scores decreased significantly,with P<0.01,the difference was statistically significant.The total effective rate(95%)of group C was higher than that of group A(55%)and group B(60%),with P<0.017,the difference was statistically significant.The total effective rate of group A and group B was comparable,with P>0.017,the difference was not statistically significant.Serum IL-17 A and IL-23 levels were significantly higher in AD patients than in normal controls(both P<0.01).After 4weeks of treatment,serum IL-17 A and IL-23 levels in AD patients were significantly lower than those before treatment,with p<0.01,which was statistically significant.The serum levels of IL-17A(pre r=0.769,post r=0.779)and IL-23(pre 0.674,post r=0.634)were positively correlated with SCORAD before and after treatment in AD patients,with all P<0.01,which was statistically significant.Conclusion: The clinical results of atopic dermatitis treatment with Desonide cream in combination with NB-UVB are better than one of them alone.Peripheral serum IL-17 A and IL-23 levels are higher in AD patients than in normal subjects,and the therapeutic effects of Desonide cream,NB-UVB treatment and their combination in AD patients may be related to the down-regulation of IL-17 A and IL-23 levels.IL-17 A and IL-23 can be used as indicators of improvement in patients with atopic dermatitis.