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

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Abstract:

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 × DHA SPF 3 in turbo-PUVA group. UVA increments used were 0.5–1.5 J/cm2 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/cm2, 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/cm2, 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.

Keywords: dihydroxyacetone; psoriasis; treatment; turbo-PUVA

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1600-0781.2010.00523.x

Affiliations: Dermatology and Venereology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Publication date: August 1, 2010

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