Efficacy of photochemotherapy on severe pruritis in polycythemia vera

Abstract

Pruritus may cause severe chronic discomfort to PV patients. Most of the usual treatments are not at all or only weakly efficient. Photochemotherapy using psoralen and ultraviolet A light may largely improve the clinical symptom of intractable itching, as observed in ten of the 11 cases presented, but maintenance therapy is generally necessary. The treatment may then improve the patient's quality of life.

Ultraviolet phototherapy for pruritus

“…A case study of successful treatment of PCV pruritus with UVA/B (315–400 nm) combination has been reported (72). Eleven patients treated with 8‐MOP PUVA two to three times a week showed successful treatment in 10 of the patients; complete alleviation of symptoms took around 15 treatments (73). The mechanism for the efficacy of phototherapy and photochemotherapy in PCV has not been elucidated.…”

Polycythemia vera‐associated pruritus and its management

“…Three of four patients with PV-associated pruritus showed good-to-excellent responses to therapy with danazol [45]. Phototherapy has been found useful in controlling PV-associated pruritus [46,47]. Narrow band ultraviolet B (UVB) phototherapy leads to complete remission of PV-associated pruritus in 8 of 10 patients [48].…”

“…Good (efficacious in 8 of 10 patients) [5,50] Phototherapy Good [7,[46][47][48][49] JAK inhibitor Promising early results [57,58] mTOR inhibitor Promising early results [53] Antihistiminics (H1 and H2 blockers)…”

How I treat patients with polycythemia vera

“…53 Other treatment options include paroxetine (20 mg/d 70 ), a selective serotonin uptake inhibitor, and photochemotherapy using psoralen and ultraviolet A light. 71 …”