title: [Clinical and immunological aspects of extracorporeal photochemotherapy for psoriasis and psoriatic arthritis].
abstract: OBJECTIVE
  To evaluate the clinical efficiency of extracorporeal photochemotherapy (EPCI) in the treatment of psoriasis (Ps) and Ps associated with psoriatic arthritis (PsA).
  
  
  METHODS
  Ninety-three patients with different forms of psoriasis were examined. A study group (SG) comprised 52 patients who were treated with EPCT; a control group (CG) included 41 patients. All the patients received pharmacotherapy generally accepted for these diseases. The SG patients were given additionally EPCT (the patient took 8-methoxypsoralen in a dose of 0.6 mg/kg 1.5-2 hours before the procedure). Mononuclear cells were isolated from the patients' blood in the intermittent-line mode on a Haemonetics MCS+ cell separator. The cell suspension was irradiated with ultraviolet light A (lambda = 320-400 nm) on a JULIA irradiator at 10-15 mI/mm for 30 mm and reinfused in the patient. The course of therapy consisted of 4 sessions performed on alternate days.
  
  
  RESULTS
  A varying positive effect was obtained in 49 (94%) SG patients; the mean PASI scores fell from 19.7 +/- 3.4 to 6.7 +/- 2.1 (p < 0.05). The DAS reflecting the activity of PsA reduced on average from 3.35 +/- 0.7 to 2.16 +/- 0.5 (p < 0.05), which corresponded to the change of PsA activity from moderate to weak. In CG, the positive effect was less pronounced in 27 (66%) patients, the PASI scores dropped on average from 19.2 +/- 3.7 to 12.2 +/- 3.1 (p < 0.05), DAS in patients with PsA decreased from 3.24 +/- 0.8 to 2.95 +/- 0.7 (p < 0.05).
  
  
  CONCLUSIONS
  EPCT showed a high efficiency in patients with psoriasis and Ps associated with PsA; the immunological studies demonstrated the pathogenetic direction of the technique.
authors.forename: V A
authors.initials: VA
authors.lastname: Molochkov
authors.forename: A V
authors.initials: AV
authors.lastname: Kil'diushevskiĭ
authors.forename: A V
authors.initials: AV
authors.lastname: Molochkov
authors.forename: O V
authors.initials: OV
authors.lastname: Karzanov
authors.forename: E S
authors.initials: ES
authors.lastname: Iakubovskaia
authors.forename: V A
authors.initials: VA
authors.lastname: Fedulkina
mesh_terms: D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000188:drug therapy / Q000209:etiology / Q000276:immunology / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods*; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008730:Methoxsalen / Q000008:administration & dosage*; D008875:Middle Aged; D017893:Photopheresis / Q000295:instrumentation / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D006634:Histamine H1 Antagonists; D017319:Photosensitizing Agents; D008730:Methoxsalen