Cream-PUVA-phototherapy

Bath-PUVA-photochemotherapy lacks systemic side effects and requires low cumulative UVA dosis, but a major disadvantage is the logistical requirement for bath tubs in a practice. We have developed an alternative form of topical PUVA therapy using a lipophilic emulsion vehicle for the photosensitizer 8-MOP (cream-PUVA-photochemotherapy). A 0.0006% 8-MOP containing water-in-oil emulsion (30% H2O) was optimal for inducing photosensitivity in treated skin areas without increasing 8-MOP plasma levels. Increased skin photosensitivity was maximal 1 hour after cream application and persisted for 3 hours. We next assessed the effectiveness of cream-PUVA-photochemotherapy in the treatment of patients with chronic recalcitrant palmoplantar eczema (n=10). In seven patients complete, and in two patients partial, remissions were observed after 40 treatments. Thus, cream-PUVA-photochemotherapy, which is easier to perform than bath-PUVA-photochemotherapy, is an effective, safe and low-cost modality, which may prove to become the topical PUVA therapy of choice for dermatological practioners.