Bath PUVA in Severe and Refractory Atopic Dermatitis

Abstract

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease. Phototherapy is considered as an effective treatment modality in severe cases. Objectives: In this study, we proposed to evaluate the efficacy of bath PUVA (psoralen plus ultraviolet A) in the treatment of severe and atopic dermatitis. Patients and Methods: Twenty-eight patients with severe atopic dermatitis were included in this quasi-experimental study. Four patients left the study. Remained cases underwent a three-month (thrice weekly, a total of 39 sessions) phototherapy protocol. We started phototherapy with 0.7 J/cm 2 and increased 0.5 J/cm 2 every two sessions to reach a maximum of 12 J/cm 2 . For assessing the efficacy, SCORAD score was determined before starting phototherapy and then at the end of the first, second, and third months after intervention. All adverse effects were recorded during the investigation period. Results: Twenty-four patients included 16 females and eight males were evaluated. Their mean age was 29.39 ± 15.17 years (ranging from 10 to 65 years). Mean of SCORAD was 65.16 ± 11.18 at the beginning of study, 52.04 ± 14.95 at the end of the first month, 40.17 ± 15.90 at the end of the second month, and 30.14 ± 20.84 at the end of the study. Decreasing in SCORAD scores was statistically significant (P < 0.0001). The most common adverse events during the study were hyperpigmentation (83.3%) and xerosis (58.3%). Conclusions: Bath PUVA was effective in the treatment of severe and refractory atopic dermatitis.