Comparison of oral psoralen-UV-A with a portable tanning unit at home vs hospital-administered bath psoralen-UV-A in patients with chronic hand eczema: an open-label randomized controlled trial of efficacy.
OBJECTIVE
To study whether oral psoralen-UV-A (PUVA) with a portable tanning unit at home is as effective as hospital-administered bath PUVA in patients with chronic hand eczema.


METHODS
Open-label randomized controlled trial, with a 10-week treatment period and an 8-week follow-up period.


METHODS
Two university hospital dermatology departments in the Netherlands, specializing in hand eczema.


METHODS
One hundred fifty-eight patients with moderate to severe chronic hand eczema (more than 1 year in duration).


METHODS
Oral PUVA using methoxsalen capsules and a simple portable commercial facial tanning unit, or hospital-administered bath PUVA with trioxsalen.


METHODS
The primary outcome was clinical assessment by a hand eczema score (evaluation of desquamation, erythema, vesiculation, infiltration, fissures, itch, and pain, each on a 4-point scale) after 10 weeks of treatment. The secondary outcome was hand eczema score at 8 weeks of follow-up, after completion of treatment. The tertiary outcome was travel cost and time off work.


RESULTS
Both groups showed a comparable and substantial decrease in hand eczema score (meaningful clinical improvement). This decrease was maintained during the follow-up period. Patients treated with oral PUVA at home had lower travel costs and less time off work.


CONCLUSIONS
Oral PUVA at home has a clinically relevant efficacy, similar to that of hospital-administered bath PUVA. This effect was maintained during an 8-week follow-up period. It resulted in lower travel costs and less time off work.
van Coevorden
A Marco
AM
Department of Dermatology, University Hospital Groningen, Groningen, The Netherlands.
Kamphof
Willeke G
WG
van Sonderen
Eric
E
Bruynzeel
Derk P
DP
Coenraads
Pieter-Jan
PJ
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001494:Baths; D002214:Capsules; D002908:Chronic Disease; D004485:Eczema / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006229:Hand Dermatoses / Q000188:drug therapy*; D006699:Home Care Services; D006801:Humans; D008297:Male; D008730:Methoxsalen / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D011701:PUVA Therapy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
D002214:Capsules; D008730:Methoxsalen