UVA/UVA1 phototherapy and PUVA photochemotherapy in connective tissue diseases and related disorders: a research based review.
BACKGROUND
Broad-band UVA, long-wave UVA1 and PUVA treatment have been described as an alternative/adjunct therapeutic option in a number of inflammatory and malignant skin diseases. Nevertheless, controlled studies investigating the efficacy of UVA irradiation in connective tissue diseases and related disorders are rare.


METHODS
Searching the PubMed database the current article systematically reviews established and innovative therapeutic approaches of broad-band UVA irradiation, UVA1 phototherapy and PUVA photochemotherapy in a variety of different connective tissue disorders.


RESULTS
Potential pathways include immunomodulation of inflammation, induction of collagenases and initiation of apoptosis. Even though holding the risk of carcinogenesis, photoaging or UV-induced exacerbation, UVA phototherapy seems to exhibit a tolerable risk/benefit ratio at least in systemic sclerosis, localized scleroderma, extragenital lichen sclerosus et atrophicus, sclerodermoid graft-versus-host disease, lupus erythematosus and a number of sclerotic rarities.


CONCLUSIONS
Based on the data retrieved from the literature, therapeutic UVA exposure seems to be effective in connective tissue diseases and related disorders. However, more controlled investigations are needed in order to establish a clear-cut catalogue of indications.
Breuckmann
Frank
F
Department of Dermatology, Ruhr-University Bochum, 44791 Bochum, Germany. Frank.Breuckmann@ruhr-uni-bochum.de.
Gambichler
Thilo
T
Altmeyer
Peter
P
Kreuter
Alexander
A
D000328:Adult; D002648:Child; D003240:Connective Tissue Diseases / Q000188:drug therapy* / Q000532:radiotherapy*; D005208:Fasciitis / Q000188:drug therapy / Q000532:radiotherapy; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D011701:PUVA Therapy; D012594:Scleroderma, Localized / Q000188:drug therapy / Q000532:radiotherapy; D012595:Scleroderma, Systemic / Q000188:drug therapy / Q000532:radiotherapy; D014467:Ultraviolet Therapy