Toxic hepatitis from oral methoxsalen photochemotherapy (PUVA).
A 59-year-old white woman with long-standing psoriasis, who had a damaged liver from methotrexate, developed a toxic hepatitis while on oral methoxsalen photochemotherapy (PUVA). Fever and marked elevation of liver enzymes occurred after the fifteenth PUVA treatment and spontaneously returned to normal within 5 days. One week later, following the next PUVA treatment, the same toxic hepatitis developed and again spontaneously resolved. Topical methoxsalen photochemotherapy with ultraviolet A (UVA) did not produce the toxic hepatitis and provided a suppression of the psoriasis on a maintenance basis.
D000284:Administration, Oral; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D005260:Female; D006801:Humans; D008730:Methoxsalen / Q000008:administration & dosage; D008875:Middle Aged; D011701:PUVA Therapy / Q000009:adverse effects*; D010778:Photochemotherapy / Q000009:adverse effects*; D011565:Psoriasis / Q000188:drug therapy
D008730:Methoxsalen