Oral PUVA Versus Bath PUVA in Chronic Plaque Psoriasis: A Comparative Study of Efficacy

Katarina Kieselova; Felicidade Santiago; Martinha Henrique

doi:10.29021/spdv.76.2.889

Katarina Kieselova Interna de Dermatologia e Venereologia/Resident of Dermatology and Venereology, Centro Hospitalar de Leiria http://orcid.org/0000-0002-0064-7571
Felicidade Santiago Assistente Hospitalar de Dermatologia e Venereologia/Consultant of Dermatology and Venereology, Centro Hospitalar de Leiria
Martinha Henrique Chefe de Serviço, Diretora do Serviço de Dermatologia/Consultant Chief, Head of Department of Dermatology Centro Hospitalar de Leiria, Leiria, Portugal

DOI: https://doi.org/10.29021/spdv.76.2.889

Keywords: Administration, Oral, Topical, Baths, PUVA Therapy/methods, Psoriasis/therapy

Abstract

Introduction: Phototherapy has long been recognized as beneficial for psoriasis treatment, with a favorable risk- -benefit relation. Photochemotherapy comprises the use of psoralen, either orally (oral PUVA) or topically (bath PUVA), prior to UVA irradiation. Oral administration of psoralen may lead to short or long-term side effects. Bath PUVA is particularly useful to minimize systemic toxicity and psoralen side effects. The aim of this study was to compare the effectiveness of these two PUVA modalities.

Material and Methods: A retrospective review of patients with chronic plaque psoriasis treated with PUVA therapy (oral and bath) in our dermatology department, between January 2001 and December 2016.

Results: We performed 81 treatments with oral PUVA and 38 treatments with bath PUVA, in 68 and 26 patients, respectively. The mean age of the patients was 50,6 years. Oral PUVA group achieved PASI 75 in 68 cases (89.5%), and bath PUVA group in 26 (74.3%), with p-value=0 .05. The mean total dose needed to achieve PASI 75 in the oral PUVA group was 113.1 J/cm2 and in the bath PUVA group was 69.8 J/cm2. The mean number of sessions performed to achieve remission in the oral PUVA group was 23.31, and in the bath PUVA group was 17.58.

Conclusion: Despite requiring specialized equipment and being more time consuming, bath PUVA represents one of the most effective therapies available for psoriasis and it should be considered as a treatment option for patients who are not candidates for systemic treatment.

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