BACKGROUND: Both oral and bath PUVA with 8-methoxypsoralen (8-MOP) have been shown to be effective in the treatment of chronic palmoplantar eczema. However, most studies were retrospective and did not include longer follow-up periods. AIM: To compare the therapeutic efficacy, tolerability and duration of remission after oral vs. bath PUVA using 8-MOP in patients with chronic palmoplantar eczema. METHODS:Twenty-nine patients were randomly allocated to treatment with oral or bath PUVA. Treatment was given thrice weekly for a maximum of 20 weeks. The primary outcome measure was the improvement in eczema score at the end of treatment. After clearing patients were followed up until relapse or up to 40 months. RESULTS: Overall, both PUVA modalities appeared comparably effective. However, after stratifying according to eczema type, significant differences in therapeutic outcome in general as well as in response to the two regimes were found. Dyshidrotic eczema responded better to both treatments (P=0.048) and remained longer in remission than hyperkeratotic eczema. Hyperkeratotic eczema cleared significantly better with oral than with bath PUVA (P=0.03). CONCLUSION:Oral PUVA is preferable for patients with hyperkeratotic eczema and bath PUVA for patients with dyshidrotic eczema.
RCT Entities:
BACKGROUND: Both oral and bath PUVA with 8-methoxypsoralen (8-MOP) have been shown to be effective in the treatment of chronic palmoplantar eczema. However, most studies were retrospective and did not include longer follow-up periods. AIM: To compare the therapeutic efficacy, tolerability and duration of remission after oral vs. bath PUVA using 8-MOP in patients with chronic palmoplantar eczema. METHODS: Twenty-nine patients were randomly allocated to treatment with oral or bath PUVA. Treatment was given thrice weekly for a maximum of 20 weeks. The primary outcome measure was the improvement in eczema score at the end of treatment. After clearing patients were followed up until relapse or up to 40 months. RESULTS: Overall, both PUVA modalities appeared comparably effective. However, after stratifying according to eczema type, significant differences in therapeutic outcome in general as well as in response to the two regimes were found. Dyshidrotic eczema responded better to both treatments (P=0.048) and remained longer in remission than hyperkeratotic eczema. Hyperkeratotic eczema cleared significantly better with oral than with bath PUVA (P=0.03). CONCLUSION: Oral PUVA is preferable for patients with hyperkeratotic eczema and bath PUVA for patients with dyshidrotic eczema.
Authors: Wietske Andrea Christoffers; Pieter-Jan Coenraads; Åke Svensson; Thomas L Diepgen; Janine L Dickinson-Blok; Jun Xia; Hywel C Williams Journal: Cochrane Database Syst Rev Date: 2019-04-26
Authors: Jochen Brasch; Detlef Becker; Werner Aberer; Andreas Bircher; Birger Kränke; Kirsten Jung; Bernhard Przybilla; Tilo Biedermann; Thomas Werfel; Swen Malte John; Peter Elsner; Thomas Diepgen; Axel Trautmann; Hans F Merk; Thomas Fuchs; Axel Schnuch Journal: Allergo J Int Date: 2014
Authors: Diêgo Madureira de Oliveira; Marcel Tavares de Farias; André Lacerda Braga Teles; Manoelito Coelho Dos Santos Junior; Martins Dias de Cerqueira; Rute Maria Ferreira Lima; Ramon Santos El-Bachá Journal: Front Cell Neurosci Date: 2014-09-30 Impact factor: 5.505