Balneophotochemotherapie des Lichen ruber

Abstract

Twelve patients with extensive lichen planus, resistant to different regimes of prior external and internal therapy, were treated with PUVA-bath photochemotherapy (psoralen bath followed by UVA irradiation) using bath water containing 0.5 mg/L of 8-methoxypsoralen (8-MOP). In 11 of the 12 patients, the skin lesions showed a significant improvement or even complete remission within six weeks of treatment. In one patient, only limited clinical improvement could be achieved. A mean of 19.1 (SD +/- 3.6) PUVA-bath treatments were carried out. The mean cumulative UVA-dose given until clearance of the lichen planus was 16.7 (SD +/- 4.8) J/cm2. No side effects were seen except an increased phototoxic reaction in two patients manifested as slight erythema. The results of this trial show, that PUVA-bath photochemotherapy with 8-MOP is an effective therapeutic alternative to all other known therapies in the treatment of extensive, exanthematic and also hypertrophic-hyperkeratotic lichen planus. In comparison to oral PUVA therapy and PUVA-bath therapy using 4,s',8-trimethoxypsoralen, balneophotochemotherapy with 8-MOP shows an excellent efficiency-side effect correlation. The clearance of the refractive skin lesions by balneophotochemotherapy with 8-MOP demonstrates the superiority of this therapy over all other common therapeutic modalities used for lichen planus.

PUVA‐bath photochemotherapy (PUVA‐soak therapy) of recalcitrant dermatoses of the palms and soles

“…Based on our extensive experience in the management of psoriasis vulgaris, atopic eczema, cutaneous T-cell lymphoma, localised scleroderma and a variety of other chronic dermatoses (1,(18)(19)(20)(21)(22)(23), we investigated the efficacy of topical PUVAbath therapy of the palms and soles (ΩPUVA-soak therapy) on a group of 30 patients with palmoplantar dermatoses resistant to prior therapy.…”

High Plasma Levels of 8-Methoxypsoralen following Bath Water Delivery in Dermatological Patients

“…After oral PUVA therapy (0.8 kg 8-MOP/kg body weight), serum levels varied between 45 and 360 ng/ml 1.5 h after drug administration. In 12 patients with lichen ruber, 8-MOP plasma levels were under the detection limit of 5 ng/ml after bath PUVA [20]. Systemic absorption of psoralens after bath PUVA treatment was !10 ng/ml at a bath 8-MOP dilution of 0.2-4.6 mg/l in further publications [6].…”

Phototherapy and Photochemotherapy: Less Common Indications for Use

“…In most of the bath studies, trioxsalen was used, although Kerscher et al [70] successfully employed 8-methoxypsoralen (8-MOP) in four patients who needed only lowish cumulative UVA doses (7.2-11.2 J/cm 2 ) for clearance, while improvements in the non-treated mucosal lesions of three patients again suggested a systemic PUVA effect. The same group later confirmed the efficacy of bath PUVA in 12 further patients [154], all except one responding completely within 6 weeks, but with slightly higher cumulative doses (10.1-23.9 J/cm 2 ).…”