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8‐MOP PUVA for psoriasis: a comparison of a minimal phototoxic dose‐based regimen with a skin‐type approach
Author(s) -
COLLINS P.,
WAINWRIGHT N. J.,
AMORIM I.,
LAKSHMIPATHI T.,
FERGUSON J.
Publication year - 1996
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.1996.tb01155.x
Subject(s) - regimen , medicine , psoriasis , cumulative dose , dermatology , urology , gastroenterology , surgery
Summary Two ultraviolet A (UVA) regimens for oral S‐methoxypsoralen (8‐MOP) photochemotherapy (PUVA) for moderate/severe chronic plaque psoriasis using a half body study technique were compared. Each patient received both regimens. A higher‐dose regimen based on minimal phototoxic dose (MPD) within percentage incremental increases was given to one‐half of the body. The other half received a lower dose regimen based on skin type with fixed incremental UVA increases. Patients were treated twice weekly. Symmetrical plaques were scored to determine the rate of resolution with each regimen. In addition, the number of treatments, cumulative UVA dose and number of days in treatment to achieve overall clearance were recorded. Patients were reviewed monthly for 1 year to record remission data. Thirty‐three patients completed the study. Both regimens were effective and well tolerated. With the MPD‐based approach, the number of exposures was significantly less for patients with skin types I and II but not III. Although the cumulative UVA dose was higher with the MPU regimen for all skin types studied, the reduced number of exposures required for clearance for skin types I and II but not III, combined with thesecurity of individualized MPD testing, has practical attractions. MPD testing also identified live patients who required an increased psoralen dose and six patients who required a reduction of the initial UVA dose with the skin type regimen. Forty‐two per cent were still clear 1 year after treatment and there was no significant difference in the number of days in remission between the regimens for those whose psoriasis had recurred. The reduction in the number of exposures required lor clearance with the MPD‐based regimen may be safer and more cost effective in the long term.