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This study has aimed to compare two different therapy schedules for dishydrotic hand eczema, medium-dose UVA-1- irradiation and topical PUVA-treatment (topical psoralen and UVA). 15 patients were included in a prospective randomised study (right versus left hand) for five weeks with irradiations 3 × per week. The hand treated with 0.001 % 8-Methoxypsoralen-cream (topical PUVA) was irradiated with weekly increasing UVA-doses (cumulative UVA-dose 17,4 J/cm 2 ). Medium-dose-UVA-1 irradiation was maintained at 40 J/cm 2 (cumulative UVA-1-dose 600 J/cm 2 ). To compare therapeutical effects, a grading with DASI (Dyshidrotic Eczema Area and Severity Index) was performed. Out of 15 patients included in the study, it was possible to evaluate 11 at the end (1 × non compliance, 1 × bacterial infection, 1 × exacerbation, 1 × disease not related to the study). 15 irradiation sessions with topical-PUVA-therapy (p = 0.0498; n = 11), as well as UVA-1-therapy (p = 0.0039; n = 11) resulted in a significant decrease of the DASI compared to study start (Wilcoxon-test). With a p-value of p = 0.3070 it was not possible to identify any differences between the two therapy schedules in respect of efficacy (U-test of Mann and Whitney). Each treatment schedule was effective (reduction of DASI to more than half of the value) and safe. Therapeutic efficacy was shown with lower cumulative doses than published hitherto.

Mittel-Dosis-UVA-1- und lokale PUVA-Therapie beim dyshidrosiformen Handekzem - eine prospektive randomisierte Studie