Palmoplantar psoriasis: experience with 8-methoxypsoralen soaks plus ultraviolet A with the use of a high-output metal halide device.
The use of 8-methoxypsoralen water soaks plus ultraviolet A was evaluated retrospectively in 11 patients with moderate to severe palmoplantar psoriasis that had been resistant to previous topical therapies. Patients received twice- or thrice-weekly 30-minute hand and/or foot soaks in 8-methoxypsoralen, 2.5 mg/L, followed by UVA irradiation. The condition of one patient cleared completely, and seven showed good improvement. The range of treatments required for maximal improvement was 14 to 43 with a mean of 28. The range of maximum UVA dosage per treatment was 3.5 to 17.5 joules/cm2, and the range of cumulative UVA required for maximal improvement was 45 to 388 joules/cm2 with a mean of 165 joules/cm2. The mean serum level of 8-methoxypsoralen 60 minutes after completion of hand and foot soaks was 2.5 +/- 0.5 ng/ml compared with 95.75 +/- 10.43 ng/ml after oral 8-methoxypsoralen, 0.5 mg/kg. In our experience this treatment has been a safe and relatively effective form of therapy for resistant palmoplantar psoriasis.
Coleman
W R
WR
Division of Dermatology, UCLA School of Medicine 90024.
Lowe
N J
NJ
David
M
M
Halder
R M
RM
D000328:Adult; D000368:Aged; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy* / Q000532:radiotherapy; D006229:Hand Dermatoses / Q000188:drug therapy* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008730:Methoxsalen / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D008875:Middle Aged; D011701:PUVA Therapy; D011565:Psoriasis / Q000188:drug therapy* / Q000532:radiotherapy; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012996:Solutions; D014467:Ultraviolet Therapy / Q000295:instrumentation
D012996:Solutions; D008730:Methoxsalen