[Characterization of nonresponders in high dosage UVA1 therapy of acute exacerbated atopic dermatitis]

Abstract

High-dose UVA1 therapy is an effective treatment of patients with acute atopic dermatitis. However, some patients do not respond well to this new therapy. We attempted to further characterize the non-responder population in a retrospective study. Two closely matched groups of responders (n = 20) and non-responders (n = 20) were compared. No significant differences were observed between both groups with respect to the following parameters: skin type, minimal erythema dose, single and cumulative doses of UVA1, and peripheral blood eosinophils. However, non-responders were characterized by a highly elevated atopic score, and by high levels of total IgE and of specific IgE. Furthermore, colonization of the skin with Staphylococcus aureus occurred at higher densities, and intestinal growth of Candida albicans was more frequently observed. These data indicate that high-dose UVA1 irradiation is not effective in all patients suffering from atopic dermatitis. We conclude that non-responders with complicating infections might benefit from the combination of high-dose UVA1 therapy and antibiotic or antimycotic treatment.