Psoralen and UltraViolet A in 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 aimed to evaluate the efficacy of bath PUVA (psoralen plus ultraviolet A) in the treatment of severe and atopic dermatitis. Methods: 28 patients with severe atopic dermatitis were included in this quasi - experimental study. Four patients left the study. The remained cases underwent a three - month (thrice weekly, 39 sessions) phototherapy protocol. We started phototherapy with 0.7 J/cm2 and increased 0.5 J/cm2 every two sessions to reach a maximum of 12 J/cm2. For assessing the efficacy, the SCORAD score was determined before starting phototherapy and at the end of the first, second, and third months after the intervention. All adverse effects were recorded during the investigation period. Results: 24 patients including 16 females and 8 males were evaluated. Their mean age was 29.39 ± 15.17 years (ranging from 10 to 65 years). The mean of SCORAD was 65.16 ± 11.18 at the beginning of the 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. The decreases in the SCORAD scores were 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.