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2630 pages added, reviewed or updated during the last month (last updated: 18/4/2021)


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PUVA

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This is a form of photochemotherapy. It combines the use of a psoralen e.g. the photosensitizing drug methoxsalen with ultraviolet A phototherapy (PUVA) in the range of 320 to 400 nm.

The proposed mechanisms of action of PUVA include:

  • suppression of cell-mediated immunity
  • suppression of cell proliferation by interference with DNA synthesis

PUVA is highly effective in the treatment of psoriasis with resolution of skin lesions in over 85% of patients after 20 to 30 treatments combining drug use and ultraviolet A irradiation.

  • oral psoralen can cause nausea - patients must wear protective eyewear on the treatment days to prevent cataract formation
  • topical PUVA - patients apply psoralen paint or gel to the skin or soak in a bath of psoralen solution prior to light exposure
    • does not require wearing eyewear or taking tablets
  • there is a risk of nonmelanoma skin cancers associated with prolonged PUVA therapy
  • PUVA therapy is often combined with other treatments such as retinoids and vitamin D analogues to reduce the number of exposures required for clearance

Reference:

  1. Prescriber (2005); 16(8).
  2. Wood AJ, (1995). Treatment of psoriasis, NEJM; 332 (9): 581-7.

Last reviewed 10/2020

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