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Psoralen-UV-A Beats UV-B in Chronic Plaque Psoriasis

Despite risks, oral psoralen-UV-A therapy has its place

MONDAY, July 17 (HealthDay News) -- Despite certain risks, oral psoralen-UV-A (PUVA) therapy is more effective than narrowband UV-B therapy among chronic plaque psoriasis patients with skin types I through IV, according to the results of a study published in the July issue of the Archives of Dermatology.

Sami S. Yones, M.Sc., of King's College London in the U.K., and colleagues conducted a double-blind, randomized trial of 93 patients with chronic plaque psoriasis. Patients had as many treatments as necessary, up to 30 sessions. After clearance, patients were followed until relapse, or for up to 12 months.

Eighty-four percent of patients who received PUVA achieved clearance, compared with 65 percent who received the narrowband UV-B therapy. Participants who received the PUVA treatment required a median of 17 sessions compared with 28.5 sessions among the participants in the narrowband UV-B therapy group, and 68 percent of patients in the PUVA group were in remission six months after the study ended, compared with 35 percent of patients who received the other light therapy. Erythema occurred more frequently in patients treated with PUVA.

The study authors point out that PUVA does have marked disadvantages, namely that it "may cause nausea, requires the use of eye protection after treatment sessions, cannot be used during pregnancy, is contraindicated in patients with significant hepatic impairment or taking warfarin or phenytoin" and, most concerning, can cause non-melanoma skin cancer. But the new findings suggest that PUVA should "still be used in appropriate patients."

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