Comparison of oral psoralen-UV-A with a portable tanning unit at home vs hospital-administered bath psoralen-UV-A in patients with chronic hand eczema: an open-label randomized controlled trial of efficacy.

Abstract

OBJECTIVE:

To study whether oral psoralen-UV-A (PUVA) with a portable tanning unit at home is as effective as hospital-administered bath PUVA in patients with chronic hand eczema.

DESIGN:

Open-label randomized controlled trial, with a 10-week treatment period and an 8-week follow-up period.

SETTING:

Two university hospital dermatology departments in the Netherlands, specializing in hand eczema.

PATIENTS:

One hundred fifty-eight patients with moderate to severe chronic hand eczema (more than 1 year in duration).

INTERVENTIONS:

Oral PUVA using methoxsalen capsules and a simple portable commercial facial tanning unit, or hospital-administered bath PUVA with trioxsalen.

MAIN OUTCOME MEASURES:

The primary outcome was clinical assessment by a hand eczema score (evaluation of desquamation, erythema, vesiculation, infiltration, fissures, itch, and pain, each on a 4-point scale) after 10 weeks of treatment. The secondary outcome was hand eczema score at 8 weeks of follow-up, after completion of treatment. The tertiary outcome was travel cost and time off work.

RESULTS:

Both groups showed a comparable and substantial decrease in hand eczema score (meaningful clinical improvement). This decrease was maintained during the follow-up period. Patients treated with oral PUVA at home had lower travel costs and less time off work.

CONCLUSIONS:

Oral PUVA at home has a clinically relevant efficacy, similar to that of hospital-administered bath PUVA. This effect was maintained during an 8-week follow-up period. It resulted in lower travel costs and less time off work.

• Authors: A Marco van Coevorden, Willeke G Kamphof, Eric van Sonderen, Derk P Bruynzeel, Pieter-Jan Coenraads
• Journal: Archives of dermatology (Arch Dermatol) Vol. 140 Issue 12 Pg. 1463-6 (Dec 2004) ISSN: 0003-987X [Print] United States
• PMID: 15611423 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Capsules
• Methoxsalen

Topics

• Administration, Oral
• Adult
• Aged
• Ambulatory Care
• Baths
• Capsules
• Chronic Disease
• Eczema (drug therapy)
• Female
• Follow-Up Studies
• Hand Dermatoses (drug therapy)
• Home Care Services
• Humans
• Male
• Methoxsalen (administration & dosage, therapeutic use)
• Middle Aged
• PUVA Therapy (instrumentation, methods)
• Treatment Outcome