An assessment of the effect of photo-chemotherapy (PUVA) and UV-B phototherapy in the treatment of psoriasis

Abstract

SUMMARY We have shown that it is possible to produce a satisfactory clinical response with a low UV‐A dosage regime in approximately one‐third of patients with widespread chronic psoriasis. UV‐B phototherapy is as effective initially, but the improvement is not as well maintained as that resulting from photochemotherapy (PUVA). However, in view of the probability that unwanted side effects of PUVA are related to the amount of UV‐A irradiation administered, it would seem appropriate to restrict the use of the higher dosage regimes to selected patients and to those who have not responded to an initial low dosage regime or to UV‐B phototherapy.

Tanning, protection against sunburn and vitamin D formation with a UV-A 'sun-bed'

“…An emission spectrum in the visible and UV wavelength range was obtained with a spectroradiometer (Spectro-Systems Ltd). The irradiance was measured with a Waldmann PUVA meter as used in dosimetry for the UV-A photochemotherapy of psoriasis (Wolff et al, 1976;Diffey, Challoner & Kay, 1980;Kenicer et al, 1981). This instrument had been calibrated indirectly against a standardised linear thermophile (Rank-Hilger, and was used to determine the total UV-A output of the fluorescent tubes of the sun-bed.…”

Dead‐Sea climatotherapy versus other modalities of treatment for psoriasis: comparative cost‐effectiveness

“…UVB phototherapy was found to be effective initially, but the improvement is not as well maintained as that resulting from photochemotherapy (PUVA). In view of the probability that the unwanted side‐effects of PUVA were related to the amount of UVA irradiation administered, however, the use of high UVA doses was restricted to patients who had not responded to an initial low regimen of UVB phototherapy 47 …”

“…In view of the probability that the unwanted side-effects of PUVA were related to the amount of UVA irradiation administered, however, the use of high UVA doses was restricted to patients who had not responded to an initial low regimen of UVB phototherapy. 47 Cyclosporine has partially replaced PUVA as a highly effective treatment of psoriasis for over 10 years now. It has been demonstrated that the efficacy and side-effects of cyclosporine in psoriasis, namely hypertension and renal dysfunction, are dose-related, and that an initial dose of 3 mg/kg/day has a better risk/benefit ratio than 5 mg/kg/ day.…”

Application of controlled high dose rates in UV-B phototherapy for psoriasis

“…But the difference between the spectral composition ( Fig. i) of the two types of tubes is also important (Kenicer et al, 1981). An important difference between the spectral output of the UV-6 and the UV-21 is that the latter lamp emits 11 ^''n of its UV-B in the region between 295 and 300 nm whereas the UV-6 emits no light in this area.…”

“…UV-B phototherapy with various radiation sources has attracted increasing interest in the last few years (Tronnier & Heidbiichel, 1976;Holzle, igSo;Adrian et al, 1981;Boer, Schothorst& Suurmond, 1981;Larko, 1982). The results have been reported to be either equal to or only slightly inferior to those obtained with PUVA ( van Weelden, Young & van der Leun, 1980;Kenicer et al, 1981;Parrish, 1981;Vella Briffa et al, 1981;Boer et al, 1983). UV-B therapy has several advantages over PUVA, including the absence of nausea, much less pruritus, no photosensitivity on the day of treatment, no need for contraception, shorter irradiation times, and possibly fewer long-term oncogenic effects, although this last remains to be proved (van Weelden et al, 1980;Larko, 1982).…”