Broadband ultraviolet A in the treatment of psoriasis vulgaris: a randomized controlled trial.
BACKGROUND
Broadband ultraviolet A (BB-UVA) has been successfully used in the treatment of scleroderma, a UVA1-responsive dermatosis.


OBJECTIVE
To compare the efficacy of BB-UVA versus psoralen + UVA (PUVA) in psoriasis treatment and assess apoptosis as an effector mechanism.


METHODS
This randomized controlled trial included 61 patients with chronic plaque psoriasis randomly divided into group I or II. Group I were further randomized to either IA or IB who received UVA 10 or 15 J/cm(2) per session, respectively, while group II received PUVA. Therapy was delivered thrice weekly until clearance or 48 treatments at most. The primary outcome measured was clearance of psoriasis. Dermal lymphocytic counts and bcl-2 expression were measured in 20 patients from each group.


RESULTS
Final Psoriasis Area Severity Index scores were reduced within each group. The UVA group achieved results comparable to PUVA until session 24 but failed to match it at final evaluation, with significantly better clinical, immunohistochemical, and histopathological results achieved by PUVA (P ≤ 0.05). Both modalities caused a reduction in dermal lymphocytic counts and epidermal bcl-2 expression.


CONCLUSIONS
BB-UVA appears to be safe and acceptable for the treatment of chronic plaque psoriasis possibly through bcl-2-mediated apoptosis of keratinocytes and epidermal lymphocytes.
Department of Dermatology, Phototherapy Unit Kasr Al Aini (PUKA), Cairo, Egypt.
Medhat
M
El-Mofty
Wedad Z
WZ
Mostafa
Randa
R
Yousef
Mona R E
MR
Abdel Halim
Marwa
M
El Hawary
Hanaa
H
Abdel Kader
Soheir
S
Assaad
Bahaa B
BB
Ghannam
D000328:Adult; D020405:Dermis / Q000378:metabolism; D004817:Epidermis / Q000378:metabolism; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D011565:Psoriasis / Q000188:drug therapy* / Q000532:radiotherapy*; D012720:Severity of Illness Index; D014467:Ultraviolet Therapy
D019253:Proto-Oncogene Proteins c-bcl-2