Retrospective long-term follow-up in patients with chronic palmoplantar dermatoses after good response to bath PUVA therapy.

Abstract

BACKGROUND:

Numerous studies have confirmed the short-term effectiveness of 8-methoxypsoralen bath PUVA therapy in patients with chronic palmoplantar dermatoses; however, little is known about long-term results.

PATIENTS AND METHODS:

In this retrospective study we examined the long-term results in 79 patients (mean age: 48 years) with chronic palmoplantar dermatoses who were treated with bath PUVA three times a week over an 8-year period. A good clinical response (a reduction of more than 50% of the skin lesions) occurred after a mean of 23 treatments and a mean cumulative UVA dose of 39 J/cm(2) in 51 patients (65%). In 2007 a questionnaire was sent to these 51 patients to assess the long-term outcome.

RESULTS:

With bath PUVA treatment, the best results were found in patients with hyperkeratotic eczema (17/22; 77% good clinical response) followed by patients with palmoplantar psoriasis (26/41; 63%) and patients with dyshidrotic eczema (8/16; 50%). Thirty-four patients (67%) answered the questionnaire after a mean follow-up interval of 4.3 years (10-87 months). Among these patients, 36% reported an improved course of disease after PUVA therapy with reduced frequency and/or intensity of the skin rash, and 29% of patients reported continued complete clearance. 79% of our patients reported a long-term reduction in the use of topical corticosteroids during the follow-up period (mean: 4.3 years). In addition, 67% of patients reported a lasting improvement in quality of life.

CONCLUSIONS:

These data show that bath PUVA may have a long-term, beneficial influence on the course of disease in a majority of patients with recalcitrant chronic palmoplantar dermatoses.

• Authors: Agnes Bretterklieber, Franz J Legat, Peter Wolf, Angelika Hofer
• Journal: Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG (J Dtsch Dermatol Ges) Vol. 10 Issue 11 Pg. 814-8 (Nov 2012) ISSN: 1610-0387 [Electronic] Germany
• PMID: 22738245 (Publication Type: Journal Article)
• Copyright: © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin • JDDG • 1610-0379/2012.

Chemical References

• Furocoumarins
• Radiation-Sensitizing Agents
• 8-methylpsoralen

Topics

• Adult
• Aged
• Aged, 80 and over
• Baths (statistics & numerical data)
• Chronic Disease
• Combined Modality Therapy (statistics & numerical data)
• Eczema, Dyshidrotic (drug therapy, epidemiology, pathology)
• Female
• Follow-Up Studies
• Furocoumarins (therapeutic use)
• Germany (epidemiology)
• Humans
• Keratoderma, Palmoplantar (drug therapy, epidemiology, pathology)
• Male
• Middle Aged
• PUVA Therapy
• Prevalence
• Radiation-Sensitizing Agents (therapeutic use)
• Retrospective Studies
• Risk Factors
• Treatment Outcome