Psoralen bath plus UV-A therapy - Possibilities and limitations

Oral psoralen plus UV-A (PUVA) therapy was originally developed for the treatment of vitiligo.(1,2) With the introduction of potent UV-A irradiation sources between 1972 and 1974, UV-A irradiation following psoralen application was found to be a highly efficient therapy for psoriasis.(3-5) The acronym PUVA was created and the potential use of PUVA was investigated in a large spectrum of different inflammatory and neoplastic skin diseases.(6-8) Psoralen plus UV-A has profoundly influenced the therapeutic concepts of dermatology, as demonstrated in the recent review by Honig et al.(8) An alternative approach, psoralen bath plus UV-A therapy (PUVA bath therapy) that avoids the adverse effects associated with oral PUVA therapy has increasingly been used during recent years. Psoralen bath plus UV-A therapy is not simply a technical variant of photochemotherapy; it is obviously superior to oral PUVA, at least for some indications, and it has considerably enlarged the spectrum of diseases responsive to photochemotherapy.