中华皮肤科杂志 ›› 2023, Vol. 56 ›› Issue (10): 928-933.doi: 10.35541/cjd.20230187

• 论著 • 上一篇    下一篇

窄谱中波紫外线治疗的寻常型银屑病患者中皮肤恶性肿瘤、带状疱疹及白内障发病情况的单中心回顾性队列研究

冯昊    刘晓涵    晋红中   

  1. 中国医学科学院  北京协和医学院北京协和医院皮肤科  疑难重症及罕见病国家重点实验室  国家皮肤与免疫疾病临床医学研究中心，北京  100730
  • 收稿日期:2023-04-04 修回日期:2023-08-14 发布日期:2023-10-08
  • 通讯作者: 晋红中 E-mail:jinhongzhong@263.net
  • 基金资助:
    中央高水平医院临床科研专项（2022-PUMCH-B-092）

Incidence of cutaneous carcinoma, herpes zoster and cataracts in patients with psoriasis vulgaris receiving narrow-band ultraviolet B phototherapy: a single-center retrospective study

Feng Hao, Liu Xiaohan, Jin Hongzhong   

  1. Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China
  • Received:2023-04-04 Revised:2023-08-14 Published:2023-10-08
  • Contact: Jin Hongzhong E-mail:jinhongzhong@263.net
  • Supported by:
    National High-level Hospital Clinical Research Funding（2022-PUMCH-B-092）

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摘要： 【摘要】 目的 调查窄谱中波紫外线（NB-UVB）治疗对寻常型银屑病患者皮肤恶性肿瘤、带状疱疹及白内障发病的影响。方法 对2003年1月1日至2019年12月31日在北京协和医院皮肤科接受NB-UVB治疗的寻常型银屑病患者进行电话随访，调查皮肤恶性肿瘤、带状疱疹及白内障的发生情况，计算发病密度及其95%置信区间（CI）。按不同NB-UVB光疗累积照射次数（≤ 100次、101 ~ 300次、＞300次）、不同累积照射能量（≤ 100 J/cm2、＞100 ~ 500 J/cm2、＞500 J/cm2）以及不同平均照射频率（≤ 1.5次/周、＞1.5次/周）分组，采用单因素Cox比例风险回归模型比较组间皮肤恶性肿瘤、带状疱疹及白内障发病密度的差异，结果以风险比（HR）及其95% CI表示。结果 共160例寻常型银屑病患者完成随访，包括男99例（61.9%），女61例（38.1%），年龄［M（Q1，Q3），下同］为39（28.3，54.8）岁，累积照射次数为129.5（52，291）次，累积照射能量为226.3（71.1，688.9） J/cm2，平均照射频率为1.57（1.37，1.83）次/周。对于皮肤恶性肿瘤，随访时间为7.77（5.11，9.92）年，共随访1 288.87人年，未发现皮肤恶性肿瘤；对于带状疱疹，随访时间为7.68（5.11，9.88）年，共随访1 273.85人年，发现4例带状疱疹，估计发病密度为31.4/10 000人年［95% CI：（11.8 ~ 83.5）/10 000人年］；对于白内障，随访时间为7.72（4.84，9.83）年，共随访1 264.67人年，发现8例白内障，估计发病密度为63.3/10 000人年［95% CI：（31.7 ~ 126.2）/10 000人年］。不同累积光疗次数、能量及平均照射频率组之间带状疱疹或白内障发病密度差异均无统计学意义（均P > 0.05）。结论 接受NB-UVB治疗的寻常型银屑病患者带状疱疹及白内障的发病密度未见受累积照射次数、累积照射能量及平均照射频率的影响。

关键词: 银屑病, 紫外线疗法, 带状疱疹, 白内障, 队列研究, 皮肤恶性肿瘤, 窄谱中波紫外线, 安全性, 发病密度

Abstract: 【Abstract】 Objective To investigate the effect of narrow-band ultraviolet B （NB-UVB） phototherapy on the incidence of cutaneous carcinoma, herpes zoster and cataracts in patients with psoriasis vulgaris. Methods A telephone follow-up was conducted among patients with psoriasis vulgaris receiving NB-UVB phototherapy at the Department of Dermatology, Peking Union Medical College Hospital from January 1, 2003 to December 31, 2019. The incidence of cutaneous carcinoma, herpes zoster and cataracts was investigated, and their incidence density and 95% confidence intervals （CIs） were calculated. Subgroup analyses were performed according to the cumulative number of NB-UVB radiation（≤ 100 times, 101 - 300 times, > 300 times）, cumulative radiation energy （≤ 100 J/cm2, > 100 - 500 J/cm2, > 500 J/cm2）, and average radiation frequency （≤ 1.5 times/week, > 1.5 times/week）. Univariate Cox′s proportional hazards regression analysis was conducted to analyze differences in the incidence density of cutaneous carcinoma, herpes zoster, and cataracts between the groups, and the results were expressed as hazard ratios （HRs） and their corresponding 95% CIs. Results A total of 160 patients with psoriasis vulgaris completed the follow-up, including 99 males （61.9%） and 61 females （38.1%）. Their ages （median ［Q1, Q3］） were 39（28.3, 54.8）years, the cumulative numbers of NB-UVB radiation were 129.5 （52, 291） times, the cumulative radiation energy was 226.3 （71.1, 688.9） J/cm2, and the average radiation frequencies were 1.57 （1.37, 1.83） times/week. No cutaneous carcinoma occurred during the follow-up of 1 288.87 person-years （7.77 ［5.11, 9.92］ years）; herpes zoster occurred in 4 cases during the follow-up of 1 273.85 person-years （7.68 ［5.11, 9.88］ years）, and the estimated incidence density of herpes zoster was 31.4/10 000 person-years （95% CI: ［11.8 - 83.5］/10 000 person-years）; cataracts occurred in 8 cases during the follow-up of 1 264.67 person-years （7.72 ［4.84, 9.83］ years）, and the estimated incidence density of cataracts was 63.3/10 000 person-years （95% CI: ［31.7 - 126.2］/10 000 person-years）. No significant differences were observed in the incidence density of herpes zoster or cataracts among subgroups with different cumulative numbers of NB-UVB radiation, cumulative radiation energy and average radiation frequencies （all P > 0.05）. Conclusion The incidence of herpes zoster or cataracts may not be affected by the cumulative number of NB-UVB radiation, cumulative radiation energy or average radiation frequency in patients with psoriasis vulgaris.

Key words: Psoriasis, Ultraviolet therapy, Herpes zoster, Cataract, Cohort studies, Cutaneous carcinoma, Narrow-band ultraviolet B, Safety, Incidence density

引用本文

冯昊 刘晓涵 晋红中. 窄谱中波紫外线治疗的寻常型银屑病患者中皮肤恶性肿瘤、带状疱疹及白内障发病情况的单中心回顾性队列研究[J]. 中华皮肤科杂志, 2023,56(10):928-933. doi:10.35541/cjd.20230187

Feng Hao, Liu Xiaohan, Jin Hongzhong. Incidence of cutaneous carcinoma, herpes zoster and cataracts in patients with psoriasis vulgaris receiving narrow-band ultraviolet B phototherapy: a single-center retrospective study[J]. Chinese Journal of Dermatology, 2023, 56(10): 928-933.doi:10.35541/cjd.20230187