Topical PUVA Therapy for Chronic Hand Eczema

Abstract

Seventeen patients with persistent chronic hand eczema were treated with topical 0.1% 8-methoxypsoralen and UVA (PUVA) for 8 weeks. Significant improvement was achieved in 5 cases (29%), moderate improvement in 9 (53%), and little improvement in 3 (18%). The mean number of PUVA treatments was 22.2, and the mean total UVA dose was 63.5 J/cm2. There was no association between clinical response and duration of hand eczema, positive patch test reaction, or atopic status. Since topical PUVA has no risk of systemic side effects, it should be considered as an alternative treatment for patients with chronic hand eczema who are resistant to other topical medications.

Efficacy of topical PUVA soaks for palmoplantar dermatoses: an audit

“…The 51.3% positive response to topical PUVA identified by this study is disappointing in comparison with results quoted elsewhere (6–10). One possible explanation for this is a lower mean number of treatments (18.4) compared with other studies [22.2 and above (6–9)]. Indeed using multivariate analysis, we found the number of treatments to be a statistically significant variable ( P =0.04).…”

“…Interestingly, the study by Taylor et al (8) found that an a mean 41 treatments were required to induce clearing, whereas none of our study group received more than 35. The average cumulative UVA dose was also lower than that found in other studies (6–10). This is not surprising as the number of treatments is a major contributor to the cumulative dose.…”

“…This audit was designed to evaluate the effectiveness of topical PUVA for hand and foot dermatoses in the NHSCT. As current literature has shown that in excess of 70% response can be expected from topical PUVA (6–10), this figure was used as our standard. Additional aims of this audit were to compare the effectiveness of topical PUVA in eczema vs. psoriasis, hands vs. feet, and also between the two UVA treatment protocols in use in the NHSCT.…”

Successful treatment of refractory chronic hand eczema with calcipotriol/betamethasone ointment: A report of three cases

“…Psoralen plus ultraviolet therapy may be considered as a second-line option when topical corticosteroids are ineffective. Although its efficacy is limited, it is considered to be relatively safe (3,7). Systemic treatments are indicated for refractory CHE, the majority of which have not been investigated in randomized clinical trials and are therefore prescribed off-label (2,3,8).…”

Treatment of Eczema

“…Over 80% of patients had at least a moderate improvement in symptoms. The results were independent of duration of hand eczema, positive patch test reaction or atopic status [79]. Topical corticosteroids have also been effective in the treatment of hand eczema.…”