Comparison of turbo-PUVA and conventional American-style PUVA in the treatment of psoriatic patients.

摘要

BACKGROUND: Ultraviolet (UV)A protective properties of dihydroxyacetone (DHA) have been used as a topical UV-resisting barrier to optimize psoralens and UVA (turbo-PUVA). Starting doses and increments were based on the DHA diffuse reflectance spectroscopy-derived protection factor. OBJECTIVE: To evaluate the efficacy of turbo-PUVA in psoriatic patients using a simpler method for determining starting doses and increments, in comparison to the conventional American-style PUVA photochemotherapy. METHODS: Thirty psoriasis patients (15 on American-style PUVA and 15 on turbo-PUVA) were evaluated, each receiving PUVA twice weekly. Starting UVA dose was determined according to skin phototype for the American-style PUVA group and according to the patient's skin phototype x DHA SPF 3 in turbo-PUVA group. UVA increments used were 0.5-1.5 J/cm(2) per treatment in American-style PUVA and 25% of the previous dose in turbo-PUVA. RESULTS: Turbo-PUVA group showed a significantly lower mean cumulative dose, a significantly higher psoriasis area and severity index score reduction, lesser mean number of treatment sessions, and less duration of treatment till remission (188.44+/-106.2 J/cm(2), 92.164+/-1.975%, 11.2+/-3.52 session, and 1.4+/-0.44 months, respectively) than conventional American-style PUVA group (255.13+/-18.304 J/cm(2), 74.725+/-10.976%, 30+/-0.00 sessions, and 3.75+/-0.00 months, respectively). CONCLUSION: Turbo-PUVA is more effective and time convenient for the treatment of psoriasis with less cumulative dose than the conventional American-style PUVA.