title: Failure of short-term psoralen and ultraviolet A light maintenance treatment to prevent early relapse in patients with chronic recurring plaque-type psoriasis.
abstract: BACKGROUND
  Photochemotherapy using psoralen and ultraviolet A light (PUVA) is a highly effective treatment option for patients with severe psoriasis. Maintenance treatment has been advocated to provide for sustained remission. However, only a few studies have been conducted to assess the efficacy of maintenance treatment and these have provided inconsistent results.
  
  
  METHODS
  We performed a prospective intrapatient left-right comparison study in 34 patients with chronic relapsing plaque psoriasis. PUVA treatment for clearing was given four times weekly. After complete or near-complete clearing, all patients were placed on a halfside maintenance schedule with irradiation twice weekly and then once weekly for 4 weeks each. The psoriasis area and severity index score was determined at baseline, end of the clearing phase and at 2-monthly intervals after discontinuation of treatment.
  
  
  RESULTS
  Using a short-term maintenance protocol, a moderate delay in relapse of psoriasis was observed in only three patients (8.8%; 95% CI: 1.8-23.6%). In the remaining patients (91.2%), maintenance treatment had no effect on the length of remission. The mean time interval until relapse without and with maintenance irradiation was 4.5 +/- 3.4 and 4.6 +/- 3.4 months, respectively.
  
  
  CONCLUSIONS
  Our data indicate that short-term maintenance treatment is not effective in preventing early relapse of psoriasis and should be avoided.
authors.affiliation: Department of Dermatology, Division of Special and Environmental Dermatology, University of Vienna Medical School, Vienna, Austria.
authors.forename: Sonja
authors.initials: S
authors.lastname: Radakovic
authors.forename: Arno
authors.initials: A
authors.lastname: Seeber
authors.forename: Herbert
authors.initials: H
authors.lastname: Hönigsmann
authors.forename: Adrian
authors.initials: A
authors.lastname: Tanew
mesh_terms: D000328:Adult; D002908:Chronic Disease / Q000628:therapy; D005363:Ficusin / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011565:Psoriasis / Q000628:therapy*; D055502:Secondary Prevention; D013997:Time Factors; D017211:Treatment Failure; D014467:Ultraviolet Therapy / Q000379:methods*
chemical_list: D017319:Photosensitizing Agents; D005363:Ficusin