Cutaneous hardening in a patient with systemic sclerosis successfully treated with UVA‐1 phototherapy

Utility of phototherapy in patients with systemic sclerosis: Systematic review

“…Cuenca‐Barrales et al described a case of a 47‐year‐old woman with limited cutaneous SSc (lcSSc) and a dominant impairment of hand mobility despite of continuous use of immunosuppressive treatment. Her hands mobility was noticeably improved after treatment with UVA1 in a low dose regimen (5–7.77 J/cm 2 ) and this response persisted after treatment discontinuation 21 . Improvement of hand mobility was earlier reported by Kanekura et al to occur in all of three patients with progressive SSc submitted to PUVA therapy with topical 0.3% metoxypsoralen 22 .…”

“…There is a dose‐dependent increase in the risk of squamous cell carcinoma, which becomes apparent after approximately 150 PUVA treatments, while the risk of development of basal cell carcinoma is smaller even in patients receiving high PUVA doses 45 . Undoubtedly, the risk of carcinogenesis on the skin is increased by immunosuppressive treatment, 46 and such treatment was received before 16,19–21,26,27 or continued 19–21 during the phototherapy by several patients from reviewed studies. Both immunosuppressive treatment and phototherapy may account for increased risk of melanoma and nonmelanoma skin cancer development in patients with localized scleroderma and SSc ones.…”

“…There is a dose-dependent increase in the risk of squamous cell carcinoma, which becomes apparent after approximately 150 PUVA treatments, while the risk of development of basal cell carcinoma is smaller even in patients receiving high PUVA doses. 45 Undoubtedly, the risk of carcinogenesis on the skin is increased by immunosuppressive treatment, 46 and such treatment was received before 16,[19][20][21]26,27 or continued [19][20][21]…”