Broad-band UVB versus paint PUVA for palmoplantar psoriasis treatment.
BACKGROUND
Plaque-type palmoplantar psoriasis (PPTP) is a chronic recalcitrant dermatosis with treatment modalities ranging through topical, phototherapy or systemic. Phototherapy options include various forms of ultraviolet B (UVB) and ultraviolet A with prior psoralen sensitization (PUVA). Currently, few comparative studies have been reported.


OBJECTIVE
To compare Broad-Band UVB (BB-UVB) versus paint PUVA (p-PUVA) in regard to efficacy and safety in the treatment of PPTP.


METHODS
A retrospective non-randomized cohort study comprised of all the patients with PPTP treated in our phototherapy centre during 2010-2012, either with BB-UVB or p-PUVA.


RESULTS
Among the 248 patients included in this study, 122 received BB-UVB and 126 followed p-PUVA treatment. About 36 (30%) and 53 (42%) had complete remission, 29 (24%) and 59 (47%) responded partially and 57 (47%) and 14 (11%) patients did not improve with BB-UVB and p-PUVA, respectively. The odds ratio for remission (p-PUVA: BB-UVB) was 7.9. Duration of remission was 21.9 ± 1.34 months for p-PUVA and 16.75 ± 1.83 months for BB-UVB.


CONCLUSIONS
Both BB-UVB and p-PUVA are good therapeutic options for PPTP. P-PUVA emerges as the superior treatment modality, yielding a better and more extended response. BB-UVB represents a feasible alternative in patients with milder disease or possible contraindications for p-PUVA.
a Phototherapy and Day Care Center, Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, affiliated with the Sackler Faculty of Medicine Tel Aviv University , Israel.
Alina
A
Lozinski
a Phototherapy and Day Care Center, Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, affiliated with the Sackler Faculty of Medicine Tel Aviv University , Israel.
Aviv
A
Barzilai
a Phototherapy and Day Care Center, Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, affiliated with the Sackler Faculty of Medicine Tel Aviv University , Israel.
Felix
F
Pavlotsky
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy / Q000503:physiopathology / Q000532:radiotherapy / Q000628:therapy*; D006229:Hand Dermatoses / Q000188:drug therapy / Q000503:physiopathology / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy / Q000379:methods*; D011565:Psoriasis / Q000188:drug therapy / Q000503:physiopathology / Q000532:radiotherapy / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014466:Ultraviolet Rays; D014467:Ultraviolet Therapy / Q000379:methods*
BB-UVB; p-PUVA; palmoplantar psoriasis