ПУВА - сочетание медикамнтозного лечения с ультра- фиолетовым облучением. Если Вы читаете по- английски - узнайте из предложенной внизу "Памятки для врачей", какие стредства рекомендуются в США для комплексного лечения витилиго. Ранее я уже поместила первую часть памятки - о лечении кортикостероидными кремами.
PUVA. Oxsoralen- ultra, 10- 20 mg. 1. 5 hours before UVA is the best medication. Trisolaren is poorly absorbed from the intestine. Must use UVA (not UVB). Sunlight — treat all exposed skin with UVB sunscreen, SPF 8- 10. Medical UVA box. Light exposure and dose of psoralens should produce mild erythema. This is the optimal dose. It can vary from 10 mg Oxsoralen 5 joules UVA to 30 mg + 10 joules. Each patient must be carefully titrated and individualized. Excessive erythema is harmful to melanocytes in the epidermis. Start with 10 mg Oxsoralen and 3 joules. Increase the UVA 2 joules per treatment until erythema is reached or 15 joules (an arbitrary endpoint because of time constraints). Then give the patient 20 mg Oxsoralen and 2 joules UVA. Increase 1 joule per treatment until a pinkness is noted in the white skin. Treatments should be given 2- 3 times per week, never on consecutive days. Patient wears Noir glasses on day of treatment until the next day. Sunlight — begin at 10 minutes front and back. Increase 5- 10 minutes per treatment until pink. Always use SPF 8- 10 sunscreen. Treatment requires 6- 18 months. Success rates approximately 60- 70% if done properly. Topical psoralen is EXTREMELY photosensitizing. Follow directions in the PDR with ABSOLUTE and TOTAL care. Expect all patients to blister occasionally and forewarn them.
PUVA. Oxsoralen- ultra, 10- 20 mg. 1. 5 hours before UVA is the best medication. Trisolaren is poorly absorbed from the intestine. Must use UVA (not UVB). Sunlight — treat all exposed skin with UVB sunscreen, SPF 8- 10. Medical UVA box. Light exposure and dose of psoralens should produce mild erythema. This is the optimal dose. It can vary from 10 mg Oxsoralen 5 joules UVA to 30 mg + 10 joules. Each patient must be carefully titrated and individualized. Excessive erythema is harmful to melanocytes in the epidermis. Start with 10 mg Oxsoralen and 3 joules. Increase the UVA 2 joules per treatment until erythema is reached or 15 joules (an arbitrary endpoint because of time constraints). Then give the patient 20 mg Oxsoralen and 2 joules UVA. Increase 1 joule per treatment until a pinkness is noted in the white skin. Treatments should be given 2- 3 times per week, never on consecutive days. Patient wears Noir glasses on day of treatment until the next day. Sunlight — begin at 10 minutes front and back. Increase 5- 10 minutes per treatment until pink. Always use SPF 8- 10 sunscreen. Treatment requires 6- 18 months. Success rates approximately 60- 70% if done properly. Topical psoralen is EXTREMELY photosensitizing. Follow directions in the PDR with ABSOLUTE and TOTAL care. Expect all patients to blister occasionally and forewarn them.