PUVA Therapy In The Treatment of Localized Scleroderma PDF Print E-mail
Monday, 16 November 2009 11:25
In localized Scleroderma, disease activity would tend to stop spontaneously over time. Treatment is important to reduce disabilities caused by the active phases of disease. According to Medifocus.com, there are three treatments used in the treatment of localized Scleroderma. These would include:
  • PUVA Therapy
  • Topical Photodynamic Therapy
  • Drug Therapy.

Today, we look at the PUVA Therapy.

PUVA Therapy or psoralen photochemotherapy refers to treatment with a combination of drugs known as Psoralens and UVA light (long wave ultraviolet radiation). Psoralens are compounds found in many plants which make the skin temporarily sensitive to UVA. The ancient Egyptians were the first to use psoralens for the treatment of skin diseases thousands of years ago. Medicine psoralens include methoxsalen (8-methoxypsoralen), 5-methoxypsoralen and trisoralen.

taken from http://www.flickr.com/photos/aenertia/2913943471/in/photostream/ via creative commonsPUVA therapy is used to treat several severe skin conditions including vitiligo, psoriasis, and dermatitis. It is also used in the treatment of localized Scleroderma because studies have been shown a significant reduction of collagen production with this treatment. However, some reports have indicated that the improvement in the systemic patients were less clear, and required further study and trials. According to one NY Times feature, PUVA therapy may prove useful for patients with early-onset diffuse Scleroderma, as this treatment is known to increase the risk for skin cancer.

PUVA therapy can be performed in a doctor’s office on an outpatient basis. The initial step in this treatment involves the administration of psoralen to the patient, which may be done either orally or topically. This is then followed by timed exposure to the ultraviolet light from the lamp. For oral PUVA, methoxsalen capsules are taken two hours before the appointment for treatment. For bathwater PUVA, the patient soaks in a bath containing a solution of psoralens. In most cases, treatment is undertaken two or three times each week.

As indicated above, PUVA is not without its risks and side effects.
  • There may be burning, where an overdose of PUVA results in a sunburn-like reaction called phototoxic erythema.
  • Temporary mild pricking or itching of the skin is common after treatment.
  • Nausea occurs in a quarter of those treated with psoralens.
  • PUVA usually leads to tanning which lasts several months. Although the skin appears brown it may still burn easily on sun exposure.
  • If the eyes are not protected from UV radiation, keratitis may occur. This results in red sore gritty eyes and can be very unpleasant.
  • Extensive PUVA treatment results in premature aging changes and can increase the chance of skin cancer.
The reading on PUVA therapy is quite extensive, and we have assembled a number of links, which would allow you to get started on the topic.
 
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