title: Low-dose UVA₁ phototherapy for scleroderma: what benefit can we expect?
abstract: BACKGROUND
  The first reports of the application of ultravioletA₁ (UVA₁) phototherapy for scleroderma go back only to 1995, but since then, several studies have proven its effectiveness in this disease.
  
  
  OBJECTIVE
  To evaluate the effectiveness of low-dose (35 J/cm(2) ) UVA(1) phototherapy in patients with scleroderma, trying to define the subgroups that benefit most from this treatment.
  
  
  METHODS
  Retrospective analysis of patients diagnosed with clinical and/or histological scleroderma, undergoing low-dose UVA(1) phototherapy between 2003 and 2010.
  
  
  RESULTS
  We studied 21 patients (20 women and one man) aged 10-75 years (mean 50). Eighteen with morphea performed a total of 29 treatments, with an average of 33 sessions per treatment per patient, a mean dose of 31 J/cm(2) per session and an average cumulative dose of 1662 J/cm(2) (310-4270). The three patients with systemic scleroderma underwent a total of five treatments, with an average of 26 sessions per treatment per patient, a mean dose of 29.5 J/cm(2) per session and an average cumulative dose of 1160 J/cm(2) (660-1695). Using the modified Rodnan skin score, in the group of patients with morphea, a marked improvement was found in 77.8% patients and a moderate improvement was found in 11.1% patients. In the systemic scleroderma group, a patient with complete remission of the skin sclerosis is emphasized.
  
  
  CONCLUSIONS
  Our experience allows us to conclude that low-dose UVA(1) phototherapy is a well tolerated option, with excellent results mainly in patients with morphea. This treatment is a valuable contribution to these patients, given the limited therapeutic options available.
authors.affiliation: Department of Dermatology, Coimbra University Hospital, Coimbra, Portugal. neidepereira@sapo.pt
authors.forename: N
authors.initials: N
authors.lastname: Pereira
authors.forename: F
authors.initials: F
authors.lastname: Santiago
authors.forename: H
authors.initials: H
authors.lastname: Oliveira
authors.forename: A
authors.initials: A
authors.lastname: Figueiredo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010789:Phototherapy; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000532:radiotherapy*; D014466:Ultraviolet Rays; D055815:Young Adult