title: Efficacy of bath psoralen plus ultraviolet A (PUVA) vs. system PUVA in psoriasis: a prospective, open, randomized, multicentre study.
abstract: BACKGROUND
  Plaque psoriasis is an inflammatory disease affecting approximately 2% of the population. The clinical hallmarks of psoriasis are sharply demarcated, erythematous plaques with thick scales. Photochemotherapy (psoralen plus ultraviolet A, PUVA) is one of the most effective therapies of psoriasis. The photosensitizer 8-methoxypsoralen (8-MOP) can be applied either orally (system PUVA) or topically in a warm water bath (bath PUVA).
  
  
  OBJECTIVE
  To compare bath PUVA and system PUVA in the treatment of plaque psoriasis.
  
  
  METHODS
  This was a randomized, open, prospective, multicentre trial. We included 74 patients with moderate-to-severe plaque psoriasis during a 6-week treatment and a 4-week follow-up period. Of the patients enrolled in the study, 38 received bath PUVA and 36 system PUVA.
  
  
  RESULTS
  Both treatment modalities significantly reduced the median Psoriasis Area and Severity Index (PASI) score in the intention-to-treat population. Within 6 weeks bath PUVA reduced the median PASI by 74% (16·4 to 4·2) while system PUVA did so by 62% (15·3 to 5·8). The difference between the two modalities was not significant with regard to treatment efficacy (P = 0·389).
  
  
  CONCLUSIONS
  There is no difference between bath PUVA and system PUVA in the treatment of psoriasis.
authors.affiliation: Department of Dermatology, Eberhard Karls University, Liebermeisterstrasse 25, Tübingen, D-72076, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Berneburg
authors.forename: T
authors.initials: T
authors.lastname: Herzinger
authors.forename: J
authors.initials: J
authors.lastname: Rampf
authors.forename: W
authors.initials: W
authors.lastname: Hoetzenecker
authors.forename: E
authors.initials: E
authors.lastname: Guenova
authors.forename: C
authors.initials: C
authors.lastname: Meisner
authors.forename: J
authors.initials: J
authors.lastname: Maetzke
authors.forename: T
authors.initials: T
authors.lastname: Schaefer
authors.forename: B
authors.initials: B
authors.lastname: Eberlein
authors.forename: K
authors.initials: K
authors.lastname: Scharffetter-Kochanek
authors.forename: M
authors.initials: M
authors.lastname: Rocken
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001494:Baths; D005260:Female; D006801:Humans; D008297:Male; D008730:Methoxsalen / Q000008:administration & dosage*; D008875:Middle Aged; D011701:PUVA Therapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017319:Photosensitizing Agents; D008730:Methoxsalen