Psoralen plus UVA vs. UVB-311 nm for the treatment of lichen planus.
BACKGROUND
The purpose of this study was to evaluate and compare the short- and long-term therapeutic efficacy of psoralen plus UVA (PUVA) vs. UVB-311 nm in the treatment of patients with disseminated lichen planus.


METHODS
A computerized data bank search and chart review revealed that data from a total of 28 patients, including 15 patients [11 women, four men; mean age 47 years (range, 16-65 years)] treated between 1998 and 2004 with PUVA and 13 patients [10 women, three men; mean age 51 years (range, 19-69 years)] treated with UVB-311 nm, were available at our institution for retrospective analysis.


RESULTS
All 15 patients (100%) treated with oral PUVA had a complete [n=10 (67%)] or partial [n=5 (33%)] clinical response, whereas 10 of 13 patients (77%) treated with UVB-311 nm showed complete [n=4 (31%)] or partial [n=6 (46%)] clinical response. Statistical analysis revealed that the initial response to PUVA was superior to that of UVB-311 nm (P=0.0426; Wilcoxon's exact test). There were no statistically significant differences between the PUVA- and UVB-311 nm-treated patient groups with regard to mean therapy duration (10.5 vs. 8.2 weeks; P=0.1107; unpaired, two-tailed Student's t test) or mean number of treatment exposures (25.9 vs. 22.5; P=0.1775). After a mean follow-up period of 20.5 months (range, 2-49 months) and 35.7 months (range, 3-60 months), respectively, disease recurrence or deterioration was observed in seven of 15 PUVA-treated patients (47%) and three of 10 UVB-311 nm-treated patients (30%). Kaplan-Meier lifetime table analysis revealed no statistically significant difference between the 2 treatment groups in terms of sustained overall (i.e., partial and complete) clinical response rate (P=0.8593; log-rank test).


CONCLUSIONS
Even though oral PUVA produces a better initial clinical response rate, both oral PUVA and UVB-311 nm are effective treatments for lichen planus that produce similar long-term outcomes.
Wackernagel
Alexandra
A
Research Unit for Photodermatology, Medical University Graz, Graz, Austria.
Legat
Franz J
FJ
Hofer
Angelika
A
Quehenberger
Franz
F
Kerl
Helmut
H
Wolf
Peter
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005363:Ficusin / Q000627:therapeutic use*; D006801:Humans; D008010:Lichen Planus / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000379:methods*
D017319:Photosensitizing Agents; D005363:Ficusin