Therapeutic Effectiveness of Psoralen-U V-A Bath Therapy In Psoriasis

• Published in: Actas dermo-sifiliográficas (English ed.) 2009, Vol.100 (3), p.212-221
• Main Authors: Rodríguez-Granados, M.T., Pereira-Rodríguez, M.J., Vázquez-Vizoso, F.L.
• Format: Article
• Language: English
• Subjects: baño-PUVA; eficacia terapéutica; fotoquimioterapia; fotosensibilidad; photochemotherapy; photosensitivity; psoralen-UV-A bath therapy; psoriasis; therapeutic effectiveness
• ISSN: 1578-2190; 1578-2190; 2173-5778
• DOI: 10.1016/S1578-2190(09)70047-2

The use of psoralen baths with long-wave UV radiation, known as PUVA bath therapy, is useful in the treatment of psoriasis. The therapy is not associated with systemic adverse effects and the dose of UV-A radiation administered is lower. The objectives of this study aimed to identify the variables that influence the effectiveness of PUVA bath therapy and the duration of remission, as well as to determine factors that predict relapse. It also aimed to assess the effectiveness of a protocol using the minimal phototoxic dose and to compare two concentrations of 8-methoxypsoralen. Two hundred nine patients with moderate-severe plaque psoriasis attended between 1994 and 2000 were included in the study. The characteristics and therapeutic outcomes of the sample were recorded. Survival curves were plotted for the disease-free interval after a good response to treatment. A proportional hazard model was used to assess the factors that influence the duration of remission. Therapeutic outcomes were better in patients with greater photosensitivity (p = 0.03). Application of the minimal phototoxic dose protocol was not associated with greater phototoxicity during treatment. The median duration of remission was 7 months. Those patients who had previously undergone oral PUVA therapy and those who did not achieve a substantial reduction in the psoriasis area and severity index (PASI) score were at greater risk of relapse. A lower final PASI extended the lesion-free period. El baño de psoralenos (P) e irradiación con ultravioleta de onda larga (UVA), conocido como baño-PUVA, es útil en el tratamiento de la psoriasis con la ausencia de efectos adversos sistémicos y una menor dosis de UVA administrada. El objetivo de este trabajo es identificar las variables que influyen en la efectividad del tratamiento con baño-PUVA y el período de remisión, así como determinar aquellas que permitan predecir la recidiva; valorar la efectividad de la prueba de fototoxicidad cutánea(DFM), y comparar dos concentraciones del 8-metoxipsoraleno (8-MOP). Se incluyeron 209 pacientes afectos de psoriasis en placas moderada-grave visitados en el período 1994-2000. Se realizó un estudio descriptivo de las características y resultados terapéuticos de lamuestra estudiada, y un estudio de supervivencia valorando el tiempo libre de enfermedad tras una buena respuesta al tratamiento. El análisis 0de riesgos proporcionales permitió evaluar qué factores influyeron en el período de remisión. Los pacientes co