PUVA-THERAPIE DER PSORIASIS

Translated title of the contribution: Photochemotherapy (PUVA) for psoriasis

Research output: Contribution to journalReview articlepeer-review

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Abstract

Psoralen photochemotherapy (PUVA) is a very effective treatment for psoriasis and superior to UVB-phototherapy (SUP). It is therefore indicated in all forms of severe and therapy-resistant psoriasis. In the last few years only, after some recent European studies, it could be generally proven that high UVA-cumulative doses > 1000 J/cm2 by PUVA increase the incidence of squamous cell carcinoma significantly, whereas lower doses do not have this effect. For this reason, and also to minimise the acute side effects of PUVA, such as phototoxic dermatitis and nausea, scientific research on more qualified photosensitizers and more suitable UV-spectra for psoriasis-photochemotherapy is highly interesting. As long as there are no new findings and PUVA is still performed with the classical psoralens and broad UVA-spectra, lifetime UVA-cumulative-doses by PUVA should be kept as low as possible, especially below 1000 J/cm2. Regimens for reducing UVA-dose with PUVA are frequent single treatments with near-erythematous doses (just below the minimal phototoxic dose [MPD] of the day), so that the duration of the clearing therapy is as short as possible, maintenance only in single cases, combination therapy of PUVA with oral tretinoin or topical vitamin D3. Risk patients with a history of arsen or skin tumours should be excluded; in younger patients and persons with UV-sensitivity type U (-II), accurate diagnosis is imperative and regular follow-ups are required, because a residual risk remains.

Translated title of the contributionPhotochemotherapy (PUVA) for psoriasis
Original languageGerman
Pages (from-to)84-91
Number of pages8
JournalAktuelle Dermatologie
Volume21
Issue number4
StatePublished - 1995

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