Effectiveness and Safety of Psoralen-UVA (PUVA) Topical Therapy in Palmoplantar Psoriasis: A Report on 48 Patients

Carrascosa, J.M.; Plana, A.; Ferrándiz, Carlos

doi:10.1016/j.adengl.2013.04.005

Cited by 19 publications

(23 citation statements)

References 17 publications

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“…Given the potentially higher risk of cutaneous carcinogenesis in immunocompromised patients under anti‐TNF‐ α drugs, the association of phototherapy in these patients is controversial and should be considered only for short periods. On the other hand, topical PUVA is very effective in palmoplantar lesions and, due the smaller area of irradiation, the risk of photocarcinogenesis is less significant. In our center, experience with topical PUVA for palmoplantar lesions is extremely positive.…”

Section: Discussionmentioning

confidence: 99%

Clinical management of Anti‐TNF‐alpha‐induced psoriasis or psoriasiform lesions in inflammatory bowel disease patients: a systematic review

Melo

Magina

2018

Int J Dermatology

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Tumor necrosis factor alpha inhibitors (anti-TNF-α) completely revolutionized the treatment of inflammatory bowel disease (IBD). However, anti-TNF-α-induced cutaneous side effects have been increasingly reported in the literature. Particularly, psoriasis and the recently recognized psoriasiform lesions are of particular concern, as anti-TNF-α agents are also used in the treatment of psoriasis, seemingly reflecting an immunological paradox. The clinical management of these cutaneous lesions is particularly challenging, owing to the potential need of anti-TNF-α discontinuation and scarcity of other therapeutic options. Therefore, optimization of current topical and systemic therapies and incorporation of new therapeutic agents is of great interest. Our aim is to review data in the literature regarding the clinical management of these cutaneous lesions and provide a therapeutic algorithm, supported by our experience as a tertiary referral center for IBD. Although in older reports no distinction was made, anti-TNF-α-induced psoriasiform lesions are not only more prevalent but also bear notable differences from classical psoriasis, possibly reflecting a different nosological entity. Onset of lesions has been related to periods of IBD remission, as supported by low levels of fecal calprotectin. Psoriasiform lesions can be adequately managed either by topical (glucocorticoids, calcineurin inhibitors, and antibiotics) or systemic (phototherapy, acitretin, glucocorticoids, and antibiotics) therapies and/or switch to other anti-TNF-α agents. Data referring to patients who were able to continue on the same IBD therapy ranged from 30.7 to 100%, reinforcing the importance of an adequate control of these lesions. The recently approved ustekinumab offers another step in the management of anti-TNF-α-intolerant patients.

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Section: Discussionmentioning

confidence: 99%

Clinical management of Anti‐TNF‐alpha‐induced psoriasis or psoriasiform lesions in inflammatory bowel disease patients: a systematic review

Melo

Magina

2018

Int J Dermatology

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“…However, Jensen et al [78] used PUVA soak in 21 patients with PPP and reported rapid relapses and no positive value from the treatment. The efficacy of PUVA increases in combination with oral retinoids, mainly acitretin [79,80].…”

Section: Phototherapymentioning

confidence: 99%

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

2020

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Palmoplantar pustulosis (PPP) is a chronic, recurrent skin disease belonging to the spectrum of psoriasis. It is characterized by an eruption of sterile pustules on the palms and soles. Recent studies in PPP have focused on genetic differences between pustular phenotypes and the role of the innate immunological system and the microbiome in the etiopathogenesis of the disease. Mutations in IL36RN (a major predisposing factor for generalized pustular psoriasis) were found in selected patients with PPP and were associated with earlier disease onset. Studies have shown that the interleukin (IL)-17 and IL-36 pathways might be involved in the pathogenesis of PPP. A microbiome has been demonstrated in the vesicopustules of PPP, and an abundance of Staphylococcus appears to be increased by smoking. Improved understanding of the underlying etiopathogenesis of PPP has led to advances in treatment options, and targeted therapies for PPP have been evaluated or are under evaluation against more than 12 molecules in ongoing clinical trials.

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“…Fototerapi ünitemizde, tek başına veya asitretin ile kombine edilen el-ayak banyo PUVA'nın palmoplantar psoriasisteki etkinliğini retrospektif olarak araştırdığımız çalışmamızda, ortalama seans sayısının 32 olduğu ve hastaların %75'inde orta ve belirgin derecede düzelme olduğu görülmüştür (109). Kırk sekiz palmoplantar psoriasis hastasında tek başına veya sistemik ajanlarla kombine edilerek uygulanan %0,1 8-metoksipsoralen emülsiyon PUVA ile, ortalama 48 seans sonunda hastaların %62,5'inde tatmin edici bir yanıt elde edilmiştir (110). Palmoplantar püstülozisdeki tedavi seçenekleri fototerapi açısından değerlendirildiğinde, 2006 yılındaki Cochrane derlemesinde, topikal PUVA'nın etkili olduğuna dair çok az kanıt olduğu, buna karşılık oral PUVA'nın, özellikle retinoidlerle kombine edildiğinde önemli ve etkin bir tedavi seçeneği olduğu belirtilmiştir (111).…”

Section: Psoriasiste Fototerapiunclassified

Current Approach to Phototherapy Applications in Dermatology Practice: Part 2. Phototherapy in Vitiligo, Mycosis Fungoides, Atopic Dermatitis, Sclerosing Diseases and Psoriasis

Gençosmanoğlu¹

2017

tdd

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Effectiveness and Safety of Psoralen-UVA (PUVA) Topical Therapy in Palmoplantar Psoriasis: A Report on 48 Patients

Cited by 19 publications

References 17 publications

Clinical management of Anti‐TNF‐alpha‐induced psoriasis or psoriasiform lesions in inflammatory bowel disease patients: a systematic review

Clinical management of Anti‐TNF‐alpha‐induced psoriasis or psoriasiform lesions in inflammatory bowel disease patients: a systematic review

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

Current Approach to Phototherapy Applications in Dermatology Practice: Part 2. Phototherapy in Vitiligo, Mycosis Fungoides, Atopic Dermatitis, Sclerosing Diseases and Psoriasis

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