Bath psoralen+ultraviolet A photochemotherapy vs. narrow band-ultraviolet B in psoriasis: a comparison of clinical outcome and effect on circulating T-helper and T-suppressor/cytotoxic cells.
BACKGROUND
Comparative success rates of bath psoralen+ultraviolet A (PUVA) and narrow band-ultraviolet B (NB-UVB) in psoriasis treatment are variably reported with no previous studies on the possible effect of bath PUVA on circulating CD4+ and CD8+ T cells.


OBJECTIVE
We aimed to compare the effect of bath PUVA and NB-UVB clinically and on circulating T-helper and T-suppressor/cytotoxic cells in psoriasis.


METHODS
Thirty-four psoriatic patients divided into a bath PUVA-treated group (18 patients) and a NB-UVB-treated group (16 patients) were compared regarding the disease severity by psoriasis area and severity index (PASI) score and percentage of circulating CD4+ and CD8+ T cells by flow cytometry before and after treatment.


RESULTS
After treatment, the bath PUVA group showed a significantly higher reduction of PASI score (85.44%) than the NB-UVB group (58.72%). Mean peripheral CD4+ T-cell percentage was significantly lower after [36.8; 95% confidence interval (CI) 33.80, 39.97] compared with before treatment (42.06; 95% CI 38.29, 45.83) (P<0.05) in the bath PUVA group while this difference was insignificant in the NB-UVB group (P>0.05).


CONCLUSIONS
Bath PUVA therapy is superior to NB-UVB in the treatment of moderate and severe psoriasis with mild reversible side effects. Both modalities have a systemic effect decreasing peripheral CD4+ T cells, which is more with bath PUVA.
Salem
Samar Abdallah Mohamed
SA
Department of Dermatology and Venereology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. smousasalem@yahoo.com
Barakat
Mohammad Ahmad El-Tohami
MA
Morcos
Christina Mohsen Zaki Metry
CM
D000293:Adolescent; D000328:Adult; D001494:Baths; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000528:radiation effects; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects / Q000528:radiation effects; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy / Q000009:adverse effects; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy* / Q000276:immunology / Q000532:radiotherapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014466:Ultraviolet Rays / Q000009:adverse effects; D055815:Young Adult
D017319:Photosensitizing Agents