Title: Cholestasis-Induced Pruritus Treated with Ultraviolet B Phototherapy: An Observational Case Series Study
Authors: Decock, Sofie ×
Roelandts, Rik
Van Steenbergen, Werner
Laleman, Wim
Cassiman, David
Verslype, Chris
Fevery, Johan
van Pelt, Jos
Nevens, Frederik #
Issue Date: Sep-2012
Publisher: Elsevier Science Publishers
Series Title: Journal of hepatology vol:57 issue:3 pages:637-641
Abstract: BACKGROUND & AIMS: Pruritus is a disabling complication of cholestatic liver disorders. Its management remains challenging. Ultraviolet B (UVB) phototherapy has been successfully used to treat pruritus in other indications. METHODS: This is an observational case series. The study population consists of 13 patients (10 females, mean age 52 years) with pruritus due to different cholestatic liver disorders: PBC (n=4), PSC (n=2), drug-induced (n=3) and persistant cholestasis after LT (n=4). Serum alkaline phosphatase were: 686 ± 363 μ/l and serum bile acids: 147 ± 15 μmol/l. In all patients conventional medical treatment had failed to control pruritus. Perception of pruritus was recorded by the visual analogue scale (VAS). RESULTS: The mean follow-up was 3 years. Ten patients (77%) had more than 60% reduction in perceived pruritus of which 4 had a more than 80% reduction. Median {25%-75% percentiles} VAS score before and after treatment decreased from 8.0 [8.0-10} to 2.0 {1.5-2.1} (P<0.001). The mean number of irradiations required to obtain this effect was 26 ± 17 (average duration of phototherapy: 8 weeks). No significant changes in cholestatic serum markers were observed. Four patients (30%) needed an additional phototherapy course because of recurrent pruritus and in all of them again a marked improvement of pruritus was observed. The therapy was well tolerated, except in 2 patients who developed during retreatment pronounced erythema in one and paraesthesia in the other. CONCLUSIONS: UVB phototherapy appears to be a promising and well tolerated treatment also for cholestasis-associated pruritus.
ISSN: 0168-8278
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Hepatology
Laboratory of Dermatoimmunology (+)
× corresponding author
# (joint) last author

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