title: Changes in skin physiology during bath PUVA therapy.
abstract: BACKGROUND
  Frequent bathing leads to a skin barrier damage with various changes in physiological skin parameters. Conversely, ultraviolet (UV) irradiation may improve the impaired skin barrier by reducing inflammatory reactions.
  
  
  OBJECTIVE
  The aim of this study was to investigate the changes of physiological skin parameters during a therapy with 8-methoxypsoralen (8-MOP) bathing and subsequent UVA irradiation.
  
  
  METHODS
  Thirty patients with a skin disease without barrier disruption were treated with daily bathing in a 8-MOP solution (0.0005%) and subsequent UVA irradiation. Multiple physiological skin parameters (transepidermal water loss, skin blood flow, skin colour, sebum content, skin hydration) were measured repeatedly on clinically non-affected skin on the back, forearm and forehead. In addition, patch testing with sodium lauryl sulphate (SLS) (0.5%) was performed on the forearm and on the back.
  
  
  RESULTS
  We found a moderate but significant disturbance of skin barrier and hydration on the forearm and the back (bathing + irradiation) after increasing dosages of therapy. In addition, SLS testing leads to stronger reactions.
  
  
  CONCLUSIONS
  We conclude that on clinically healthy skin the impairment of skin barrier by frequent bathing cannot be completely compensated by subsequent UVA irradiation. When conducting a treatment with 8-MOP bathing and UVA irradiation a concomitant therapy supporting the recovery of skin barrier, e.g. with moisturizer, should be performed.
authors.affiliation: Department of Dermatology, Philipp University of Marburg, Germany. Harald.Loeffler@mailer.uni-marburg.de
authors.forename: H
authors.initials: H
authors.lastname: Löffler
authors.forename: J
authors.initials: J
authors.lastname: Aramaki
authors.forename: K
authors.initials: K
authors.lastname: Friebe
authors.forename: R
authors.initials: R
authors.lastname: Happle
authors.forename: I
authors.initials: I
authors.lastname: Effendy
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy; D012039:Regional Blood Flow / Q000528:radiation effects; D012629:Sebum / Q000528:radiation effects; D012867:Skin / Q000098:blood supply; D012879:Skin Physiological Phenomena / Q000528:radiation effects*; D012880:Skin Pigmentation / Q000528:radiation effects; D014870:Water Loss, Insensible / Q000528:radiation effects