Document Detail


The effectiveness of PUVA treatment in severe psoriasis is significantly increased by additional UV 308-nm excimer laser sessions.
MedLine Citation:
PMID:  18086590     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In most cases, patients with moderate to severe psoriasis are treated with narrow-band UVB phototherapy or with psoralen UVA (PUVA-) photochemotherapy. This UV-radiation is given to the whole skin, including unaffected skin. Normally, these two PUVA- and UVB-radiation procedures cannot be combined on account of the phototherapeutic side-effects on unaffected skin. The 308-nm excimer laser has been shown to be safe and effective in the treatment of localized mild-to-moderate plaque-type psoriasis whilst sparing healthy skin. Our aim was to compare the therapeutic response to PUVA plus up to 4 UVB308-nm radiations and PUVA monotherapy in patients with moderate-severe plaque-type psoriasis. 272 hospitalized adult patients were enrolled on this prospective random study. 256 patients completed the full course of treatment. PUVA treatment was given 4 times weekly to all patients. 123 patients received PUVA as a monotherapy. During the first two weeks, 149 patients were additionally treated up to four times with 308-nm excimer-derived UVB on the affected skin and treatment was evaluated for its efficacy, duration, number of times necessary for complete (CR) or partial remission (PASI reduction > 90 or > 50%, respectively), cumulative light dose, side effects of therapy and duration of remission after therapy. Statistically, there is no significant difference when comparing the efficacy of PUVA (CR 67.3%) and PUVA plus excimer (CR 63.6%). On average, patients treated by the combination method went into remission in half the treatment time (15 +/- 6 versus 27 +/- 7 days) and with half the cumulative UVA dose (22.9 +/- 5.8 versus 53.2 +/- 26.3), p < 0.05. In conclusion, skin heals considerably quicker when treated with a combination of photochemotherapy and a short course of UVB 308 nm laser treatment applied directly to the affected skin, resulting in a shorter hospital stay and quicker rehabilitation of patients with moderate-severe psoriasis.
Authors:
Jana Trott; Wolfgang Gerber; Stefan Hammes; Hans-Michael Ockenfels
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2007-12-18
Journal Detail:
Title:  European journal of dermatology : EJD     Volume:  18     ISSN:  1167-1122     ISO Abbreviation:  Eur J Dermatol     Publication Date:    2008 Jan-Feb
Date Detail:
Created Date:  2008-01-04     Completed Date:  2008-06-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206420     Medline TA:  Eur J Dermatol     Country:  France    
Other Details:
Languages:  eng     Pagination:  55-60     Citation Subset:  IM    
Affiliation:
Department of Dermatology and Allergology, Klinikum Hanau, Leimenstrasse 20, 63450 Hanau, Germany.
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MeSH Terms
Descriptor/Qualifier:
Combined Modality Therapy
Female
Humans
Laser Therapy, Low-Level*
Lasers, Excimer*
Male
Middle Aged
PUVA Therapy*
Psoriasis / drug therapy,  therapy*
Ultraviolet Therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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