Livedoid vasculitis responding to PUVA therapy.
BACKGROUND
Livedoid vasculitis is a chronic disorder manifested as recurrent, painful, reticulated, and ulcerative lesions of the legs, which result in ivory atrophic scars with peripheral telangiectasia and hyperpigmentation. Its etiology remains obscure and therapy is difficult. In this study, we evaluated the clinical efficacy of psoralen plus UVA (PUVA) therapy and its side-effects in the treatment of livedoid vasculitis.


METHODS
Eight South Korean patients with livedoid vasculitis were treated with UVA and 8-methoxypsoralen (8-MOP). Systemic PUVA was started with 4 J/cm2 of UVA two or three times a week, and then the dose was increased by 0.5 or 1 J/cm2 increments at each subsequent treatment as tolerated. The effects of treatment were evaluated using photographs of before, during, and after the study.


RESULTS
All patients experienced rapid cessation of new lesion formation, significant symptom relief, and complete healing of primary lesions. The mean times for each of the above were 3.6, 5.9, and 10 weeks, and the mean cumulative doses of UVA for each of the above were 55.9, 96.8, and 197.9 J/cm2, respectively. The patients tolerated PUVA therapy well without unacceptable side-effects.


CONCLUSIONS
We propose that systemic PUVA using 8-MOP should be investigated further as an alternative treatment for patients with livedoid vasculitis.
Lee
J H
JH
Department of Dermatology, Yonsei University College of Medicine, Seoul, South Korea.
Choi
H J
HJ
Kim
S M
SM
Hann
S K
SK
Park
Y K
YK
D000328:Adult; D001706:Biopsy; D005260:Female; D006801:Humans; D008297:Male; D008730:Methoxsalen / Q000627:therapeutic use*; D011701:PUVA Therapy; D012867:Skin / Q000473:pathology*; D017445:Skin Diseases, Vascular / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome; D014657:Vasculitis / Q000188:drug therapy* / Q000473:pathology*
D008730:Methoxsalen