Synergistic Effects of the 308-nm Excimer Light and Topical Calcipotriol for the Treatment of Chronic Hand Eczema: A Randomized Controlled Study

摘要

Background: Though topical corticosteroid is a standard treatment for chronic hand eczema (CHE), it can cause many adverse effects. Topical calcipotriol and monochromatic 308-nm excimer light (MEL) are new alternative therapies for several dermatoses, including CHE. Objective: This study aims to compare the efficacy of the combination of MEL and topical calcipotriol versus topical calcipotriol alone. Methods: One hand of the participants was randomly assigned to be irradiated with MEL twice weekly and topical calcipotriol applied twice daily while the other hand was assigned to receive only topical calcipotriol twice daily for 8 weeks. Then, only petrolatum ointment was applied during the 4-week follow-up period. Hand Eczema Severity Index (HECSI) and modified Total Lesion Symptom Score were assessed by a blinded investigator, and a visual analogue scale score of itching symptoms was graded by the participants. Results: In total, 36 hands from 18 subjects completed the protocol. On the combination-treated sides, the mean HECSI score was significantly reduced by 25% ( p = 0.015) from the 4th week. Then, it was gradually decreased to 57 and 65% ( p < 0.001) at the 8th week and at the follow-up visit, respectively. For the monotherapy-treated sides, the mean HECSI score was reduced to 41% ( p = 0.001) and 49% ( p < 0.001) at the 8th and 12th week, accordingly. At the end of the treatment period, itching scores were significantly decreased by around 64% ( p < 0.001) and 51% ( p = 0.002) on the combination-treated and the monotherapy-treated sides. No serious and persistent adverse reactions were found. Conclusion: The combined MEL and topical calcipotriol may be considered as an alternatively effective treatment for CHE.