Long-term risks of psoralen and UV-A therapy for psoriasis

Abstract

It has been more than eight years since photochemotherapy with methoxsalen and UV-A (psoralen and UV-A [PUVA]) was introduced for the treatment of psoriasis. This treatment remained under investigation until May 1982 because of concerns about possible chronic toxic effects. With recent Food and Drug Administration approval of PUVA therapy for severe psoriasis, strict drug labeling for administration and patient use and continued monitoring of side effects have become essential. The full effects of PUVA in regard to carcinogenicity, prematurely induced aging of the skin, pigmentary changes, immunologic alterations, and ocular side effects are still unknown. A review of the risks of PUVA therapy is presented, with the aim of maintaining a proper perspective for its limited use in treating selected patients.

Ultraviolet radiation‐blocking characteristics of contact lenses: relevance to eye protection for psoralen‐sensitised patients

“…cataract formation, can be prevented by suitable eye protection. However, concerns have been raised over the possible lack of patient compliance (15,21). One of the advantages of bath-PUVA compared to systemic-PUVA is the very low systemic levels of psoralen are unlikely to pose a significant risk to the ocular lens.…”

PUVA treatment and choroidal malignant melanoma

“…Erythema, pruritus, vomiting, headache, and dizziness were reported as the short-term side effects of the treatment. The long-term complications were reported as basal cell carcinoma, bullous pemphigoid, Lupus Erythematosus, and PUVA lentigines (Lerman 1980;Woo et al 1985;Lerman et al 1980;Marxet al 1983;Coxet al 1987;Farber et al 1983). Because of its long-term side effects it should not be applied in children (Segal et al 1978).…”

Antineoplastic effect of a novel nanosized curcumin on cutaneous T cell lymphoma

“…This is because the malignant T cell clone expands at the expense of normal T cells, creating a deficiency in the number of the latter (21,22). Since the immune system is compromised in these patients, one should proceed carefully in the selection of novel therapeutic agents, opting for those that are well tolerated, in order to avoid immune collapse, given the fact that current therapies exhibit a marked immunotoxicity (23)(24)(25)(26)(27)(28)(29). This problem becomes more obvious considering that patients with CTCL are more susceptible to infections due to the impaired skin barrier caused by tumors and/or lesions (30).…”