PUVA for the Treatment of Moderate to Severe Psoriasis

Abstract

PUVA (psoralen plus ultraviolet A) phototherapy is the use of a photosensitizing medication (8-methoxypsoralen/methoxsalen/Oxsoralen Ultra) in combination with ultraviolet A (UVA) phototherapy. PUVA is used to treat moderate to severe psoriasis, generalized psoriasis, or psoriasis that is unresponsive to topical treatments. In systemic PUVA, patients take oral methoxsalen and are subsequently exposed to UVA. In topical and bath PUVA, patients expose their skin to psoralens by soaking in water containing methoxsalen or applying a topical formulation of methoxsalen, followed by exposure to UVA. Patients are treated three times per week for at least 12 week and potential ongoing maintenance treatment is required. PUVA penetrates deeper into the skin and may be more effective than UVB. Potential side effects of PUVA include burning, itching, and pigmentation of the skin, as well as nausea with systemic PUVA. There is an increased risk of skin cancer in Caucasian patients who undergo more than 250 treatments of PUVA.